Table 1.
Study design and setting overview.
| Reference | Study design | Setting | Population | Time horizon | HIV prevalencea | Perspectiveb | Intervention description |
|---|---|---|---|---|---|---|---|
| VMMC | |||||||
| Binagwaho et al. (2010) [15] | Deterministic compartmental simulation | Rwanda | 0-49 yoc, male population | Lifetime | 2.7% | Health care payer | Scale-up of VMMC to infants, adolescents, and adults |
| Njeuhmeli et al. (2011) [16] | Deterministic compartmental simulation | Sub-Saharan Africa | 15-49 yo, general population | Lifetime | 4.8% | Health care payer | Scale-up of VMMC |
| Uthman et al. (2011) [17] | Probabilistic decision analysis | Sub-Saharan Africa | 15 + yo, male population | Lifetime | 5.5% | Health care payer | Uptake of VMMC |
| Duffy et al. (2013) [18] | Cross-sectional descriptive cost-analysis | Uganda | 18 yo and older, male population | Lifetime | 5.9% | Health care payer | PrePex device for VMMC |
| Menon et al. (2014) [19] | Impact analysis | Tanzania | 10-49 yo, male population | Lifetime | 4.5% | Health care payer | Scale-up of VMMC |
| Awad et al. (2015) [20] | Deterministic compartmental simulation | Zimbabwe | 10-49 yo, male population | 15 years | 13.3% | Health care payer | Prioritisation of VMMC subpopulations by age, geographic location, sexual risk profile |
| Awad et al. (2015) [21] | Deterministic compartmental simulation | Zambia | 10-49 yo, male population | 15 yearsc | 11.5% | Health care payer | Prioritisation of VMMC subpopulations by age, geographic location, sexual risk profile |
| Haacker et al. (2016) [22] | Deterministic compartmental simulation | South Africa | 15-59, male population | Lifetime | 18.8% | Health care payer | Age prioritised VMMC scale up |
| Kripke et al. (2016) [23] | Deterministic compartmental simulation | Malawi | 10 + yo; male population | 15 years | 9.6% | Health care payer | Age prioritised VMMC scale up |
| Kripke et al. (2016) [24] | Deterministic compartmental simulation | Zimbabwe | 20-29 yo; male population | 15 years | 13.3% | Health care payer | Age prioritised VMMC scale up |
| Kripke et al. (2016) [25] | Deterministic compartmental simulation | Sub-Saharan Africa | 10-49 yo; male population | 15 years | 4.8% | Health care payer | Age prioritised VMMC scale up |
| Kripke et al. (2016) [26] | Deterministic compartmental simulation | Eswatini | 10-49 yo; male population | 15 years | 27.4% | Health care payer | Age prioritised VMMC scale up |
| Kripke et al. (2016) [27] | Deterministic compartmental simulation | Malawi, South Africa, Eswatini, Tanzania, Uganda | 10-49 yo; male population | 15 years | 9.6% (Malawi) 18.8% (South Africa) 27.4% (Eswatini) 4.5% (Tanzania) 5.9% (Uganda) |
Health care payer | Age prioritised VMMC scale up |
| Njeuhmeli et al. (2016) [28] | Deterministic compartmental simulation | Zimbabwe | Male infants | 36 years | 13.3% | Health care payer | Early infant male circumcision |
| PrEP | |||||||
| Pretorius et al. (2010) [29] | Deterministic compartmental simulation | South Africa | 15-49 yo, general population | 10 years | 18.8% | Health care payer | PrEP is scaled up to recruit all uninfected individuals |
| Hallett et al. (2011) [30] | Microsimulation | South Africa | HIV serodiscordant couples | Lifetime | 18.8% | Health care payer | PrEP for uninfected partner in serodiscordant relationships |
| Cremin et al. (2013) [31] | Deterministic compartmental simulation | KwaZulu-Natal, South Africa | 15-54 yo, general population | 10 years | 27.0% (KZNc)ref | Program | Combination prevention strategies of VMMC, early ART, and PrEP |
| Nichols et al. (2013) [32] | Deterministic compartmental simulation | Macha, Zambia | 12 + yo, general population | 10 years | 7.7% (Macha) | Health care payer | Prioritisation of PrEP |
| Verguet et al. (2013) [33] | Deterministic compartmental simulation | Sub-Saharan Africa | 15-49 yo, general population | 5 years | 4.8% | Health care payer | PrEP intervention to pre-existing levels of MC, ART, and condom use |
| Alistar et al. (2014) [34] | Dynamic compartmental simulation | South Africa | 15-49 yo, general population | 20 years | 18.8% | Health care payer | PrEP is scaled up to recruit all uninfected individuals |
| Nichols et al. (2014) [35] | Deterministic compartmental simulation | Macha, Zambia | 12 + yo, general population | 40 years | 7.7% (Macha) | Health care payer | Uptake of PrEP and TasP in combination |
| Cremin et al. (2015) [36] | Deterministic compartmental simulation | Nyanza province, Kenya | General population | 5 years | 13.9% (Nyanza) | Health care payer | Dynamic interaction between key determinants of PrEP impact and cost-effectiveness |
| Cremin et al. (2015) [37] | Deterministic compartmental simulation | Gaza province, Mozambique | Adult male mine workers | 5 years | 30.0% (female) 17.0% (male) |
Health care payer | Time-limited PrEP uptake among sexual partners of miners |
| Ying et al. (2015) [38] | Micro-costing analysis | Uganda | HIV serodiscordant couples | 10 years | 7.1% | Program | Targeted PrEP for serodiscordant couples |
| Glaubius et al. (2016) [39] | Deterministic compartmental simulation | South Africa | 15-54 yo, general population | 1) 10yrs 2) lifetime |
18.8% | Societal | Long-acting injective antiretrovirals used for PrEP |
| Walensky et al. (2016) [40] | Deterministic compartmental simulation | South Africa | 18-25 yo, high risk women | 5 years | Incidence: 5.0% (high risk women) | Program | Long-acting PrEP |
| Cremin et al. (2017) [41] | Deterministic compartmental simulation | Nairobi, Kenya | Key populations | 10 years | 4.8% | Health care payer | PrEP provided to FSW |
| TasP | |||||||
| Barnighausen et al. (2012) [42] | Discrete time mathematical model | South Africa | 15 + yo, general population | 10 years | 18.8% | Health care payer | Increased coverage of TasP, ART under the current WHO eligibility guidelines, and MMC |
| Granich et al. (2012) [43] | Deterministic compartmental simulation | South Africa | 15 + yo, general population | 1) 5 years 2) 40 years |
18.8% | Program | Enhanced combination prevention strategy |
| Smith et al. (2015) [44] | Individual-based simulation modelling study | KwaZulu-Natal, South Africa | 18 + yo, general population | 10 years | 27.0% (KZN)ref | Health care payer | Home HIV counselling and testing |
| Bershteyn et al. (2016) [45] | Individual-based simulation modelling study | South Africa | General population | 20 years | 18.8% | Health care payer | Age-targeting outreach with HIV treatment and prevention |
| Ying et al. (2016) [46] | Dynamic compartmental model | KwaZulu-Natal, South Africa | General population | 10 years | 27.0% (KZN)ref | Program | Home HIV testing and counselling |
| PMTCT | |||||||
| Halperin et al. (2009) [47] | Modelling analysis | Sub-Saharan Africa | Pregnant, HIV-infected women | 1 year | 4.8% | Service delivery | Antiretroviral prophylaxis programs and family planning programs |
| Nakakeeto et al. (2009) [48] | Forecasting model | Burkina Faso, Cameroon, Cote d’Ivoire, Malawi, Rwanda, Tanzania, and Zambia |
HIV-infected women, HIV-exposed infants | 8 years | 0.8% (Burkina Faso) 3.7% (Cameroon) 2.8% (Cote d’Ivoire) 9.6% (Malawi) 2.7% (Rwanda) 4.5% (Tanzania) 11.5% (Zambia) |
Health care payer | PMTCT package including: family planning, HIV testing and counselling, and provision of antiretroviral and cotrimoxazole prophylaxis |
| Orlando et al. (2010) [49] | Cost-effectiveness analysis | Malawi | Pregnant, HIV-infected women | 42 months | 16.9% (ANC) | Societal and Private | HAART-based intervention |
| Robberstad et al. (2010) [50] | Decision analysis | Tanzania | Pregnant, HIV-infected women | 18 months | 6.6% (ANC) | Health care payer | HAART-based intervention |
| Shah et al. (2011) [51] | Decision-based analytical model | Nigeria | Pregnant, HIV-infected women | 1 year | 2.8% | Health care payer | 2009 WHO PMTCT guidelines (long-course ART) |
| Kuznik et al. (2012) [52] | Cost-effectiveness analysis | Uganda | Pregnant, HIV-infected women | 19.3 years | 7.1% | Health care payer | Combination ART |
| Binagwaho et al. (2013) [53] | Cost-effectiveness analysis | Rwanda | HIV-infected pregnant women and their infants | Lifetime | 2.7% | Health care payer | Dual ARV and short course HAART prophylaxis with breastfeeding or replacement feeding |
| Fasawe et al. (2013) [54] | Decision analysis | Malawi | Pregnant, HIV-infected women | 10 years | 16.9% (ANC) | Health care payer | Implementation of Option B + |
| Maredza et al. (2013) [55] | Cost-effectiveness analysis | South Africa | Pregnant, HIV-infected women | 24 months | 28.0% (ANC) | Health care payer | HAART-based intervention |
| Gopalappa et al. (2014) [56] | Deterministic compartmental simulation | Kenya, South Africa, Zambia | 15-49 yo, female population | Lifetime | 5.9% (Kenya) 18.8% (South Africa) 11.5% (Zambia) |
Program | Implementation of Option B + |
| Ishikawa et al. (2014) [57] | Decision analysis | Zambia | Pregnant, HIV-infected women | 18 months | 11.5% | Health care payer | Comparison between Option A, Option B, and Option B + |
| Yu et al. (2014) [58] | Decision analysis | South Africa | Pregnant, HIV-infected women | 18 months | 28.0% (ANC) | Health care payer | 1) tested and treated promptly at any time during pregnancy (promptly treated cohort), 2) no testing or treatment until after delivery and appropriate standard treatments were offered (remedy treated cohort) |
| Zulliger et al. (2014) [59] | Cost-effectiveness analysis | South Africa | Pregnant, HIV-infected women | 1 year | 28.0% (ANC) | Health care payer | Expedited initiation onto lifelong ART in pregnant women who met South African ART eligibility criteria |
| Price et al. (2016) [60] | Decision analysis | Zambia | Pregnant women | Lifetime | 11.5% | Health care payer | Daily oral PrEP during pregnancy and breastfeeding |
| Tweya et al. (2016) [61] | Individual-based simulation modelling study | Malawi | Primigravida women | 50 years | 16.9% (ANC) | Health care payer | Option B vs. Option B + |
| Other biomedical | |||||||
| Verguet et al. (2010) [62] | Cost-effectiveness analysis | South Africa | 15-49 yo, female population | 1 year | 26.3% (Female) | Health care payer | Impact of microbicides distributed alongside condoms |
| Williams et al. (2011) [63] | Dynamic compartmental model | South Africa | General population | 20 years | 18.8% | Health care payer | Tenofovir gel uptake by sexually active women |
| Long et al. (2013) [64] | Dynamic compartmental simulation | South Africa | 15-49 yo, general population | 10 years | 18.8% | Health care payer | HIV screening and counselling, ART, VMMC, microbicides |
| Mbah et al. (2013) [65] | Dynamic compartmental simulation | Zimbabwe | 15-49 yo, female population | 10 years | 13.3% | Health care payer | Praziquantel as a preventive anthelminthic chemotherapy |
| Terris-Prestholt et al. (2014) [66] | Deterministic compartmental simulation | Gauteng Province, South Africa | 15-49 yo, general population + FSW and their partners |
15 years | 17.6% (Gauteng) | Health care payer | Uptake of tenofovir gel by women |
| Mvundura et al. (2015) [67] | Impact analysis | Sub-Saharan Africa | 15-49 yo, general population | 1 year | 4.8% | Health care payer | Distribution of 100,000 female condoms |
| Moodley et al. (2016) [68] | Semi-Markov simulation | South Africa | Adolescents enrolled in school | Lifetime | 10.2% (females 15-24) 3.9% (males 15-24) |
Health care payer | Hypothetical HIV vaccination provided to adolescent students |
| Moodley et al. (2016) [69] | Semi-Markov simulation | South Africa | Adolescents girls enrolled in school | Lifetime | 10.2% (females 15-24) 3.9% (males 15-24) |
Health care payer | National implementation of hypothetical HIV vaccination to adolescents |
| Wall et al. (2018) [70] | Cost-benefit analysis and cost-effectiveness analysis | Zambia | HIV serodiscordant couples | 5 years | 11.5% | Donor | Couples’ testing and counselling with TasP for seropositive partner |
| Behavior change | |||||||
| Enns et al. (2011) [71] | Stochastic network simulation | Eswatini, Tanzania, Uganda, Zambia | 15-49 yo, general population | 10 years | 27.4% (Eswatini) 4.7% (Tanzania) 7.1% (Uganda) 11.5% (Zambia) |
Program | Concurrency reduction campaigns focused on behaviour change scenario: 1) increased monogamy, 2) high-risk partnership reduction, 3) untargeted partnership reduction |
| Structural | |||||||
| Fieno et al. (2014) [72] | Cost simulation | South Africa | Women aged 15-20 yo, bottom quarter of income distribution | 6 years | 18.8% | Health care payer | Cash transfers |
| Remme et al. (2014) [73] | Cost-benefit analysis and cost-effectiveness analysis | Malawi | Adolescent girls attending school | 18 months | 9.6% | Health care payer | Cash transfers |
| Rutstein et al. (2014) [74] | Decision-tree model | Malawi | 15-49 yo, partners of STI clinic indexes | 1 year | 9.6% | Health care payer | Partner notification |
World Bank 2017 HIV prevalence estimates
Health care payer perspective refers to costs incurred or saved by the governmental healthcare system; Donor perspective refers to costs incurred of saved by international donors; Program and service delivery perspective refers to costs incurred by a stakeholders implementing HIV program; Societal perspective refers to all of society regardless of the payer; Private perspective takes into account the costs incurred by service providers
Abbreviations: ANC = antenatal care clinic; ARV = antiretrovirals; ART = antiretroviral therapy; FSW = female sex worker; HAART = highly active antiretroviral therapy; KZN = KwaZulu-Natal, South Africa; MC = male circumcision; MMC = medical male circumcision; PMTCT = prevention of mother-to-child transmission; PrEP = pre-exposure prophylaxis; TasP = treatment as prevention; VMMC = voluntary medical male circumcision; WHO = World Health Organization; yo = years old.