Table 3.
Studies of the cost of scaling up HIV and syphilis testing
| Study | Intervention(s) | Country | Study population | Setting | Time horizon | Study design | Type of economic analysis (and ratio if applicable) | Data source (s) | Analytical approach to measure scale |
|---|---|---|---|---|---|---|---|---|---|
| #1 (Shelley et al., 2015) | Syphilis testing/RST/POC | Zambia | Pregnant women (age not specified) | ANC clinic | 5 months | Cross-sectional study | Cost analysis | Primary data collection | Empirical |
| #2 (Schackman et al., 2007) |
Syphilis testing, comparing: #1 Syndromic surveillance/not POC #2 RPR for syphilis/not POC #3 RST/POC |
Haiti | Pregnant women (age not specified) | ANC clinic | Not specified | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #3 (Bautista-Arredondo et al., 2018a,b) | HIV voluntary and provider-initiated counselling and testing/HIV rapid test/not POC | Nigeria | General population (age not specified) | Health facility | 6 months | Cross-sectional study | Cost analysis | Primary data collection | Econometric |
| #4 (Dandona et al., 2008a,b) | HIV voluntary counselling and testing/HIV rapid test/not POC | India | General population (age not specified) | Health facility | 1 year | Cross-sectional study | Cost analysis | Primary data collection | Empirical |
| #5 (Galárraga et al., 2017) | HIV testing and counselling/HIV rapid test/not POC | Kenya | General population (age not specified) | Health facility | 22 months | Cross-sectional study | Cost analysis | Primary data collection | Econometric |
| #6 (Hontelez et al., 2013) |
HIV testing/type of test not specified/not POC, comparing: #1 ART at CD4 count ≤350 cells/µl #2 Universal testing and treatment |
South Africa | General population (aged 15–65 years) | Not specified | Lifetime | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #7 (Ishikawa et al., 2016) |
HIV testing/HIV rapid test/not POC, comparing: #1 The current coverage #2 A focused approach #3 A universal approach |
Namibia, Kenya, Haiti and Vietnam | Pregnant women (aged 15–49 years old) | ANC clinic | 20 years | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #8 (McConnel et al., 2005) | HIV rapid voluntary counselling and testing/HIV rapid test/POC | South Africa | General population (age not specified) | VCT clinic | 1 year | Cross-sectional study | Cost analysis | Primary data collection | Empirical |
| #9 (Ahaibwe and Kasirye, 2013) |
HIV testing/HIV rapid test/not POC, comparing: #1 The current coverage #2 100% coverage of adult population |
Uganda | General population (adult 15–49 years) | Stand alone, integrated w/health facility, non- health facility and mobile VCT services | Lifetime | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #10 (Alsallaq et al., 2017) |
HIV testing/HIV rapid test/not POC, comparing: #1 HIV strategies focusing on youth (15–24 years old) #2 HIV strategies focusing on adults (15+ years) |
Kenya | Youth population (aged 15–24 years) | Health facility | 20 years | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #11 (Cambiano et al., 2015) |
HIV testing/HIV rapid test/not POC, comparing: #1 Provider-delivered HIV testing and counselling #2 HIV self-testing |
Zimbabwe | General population (aged 15–65 years old) | Not specified | 20 years | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #12 (Cherutich et al., 2018) |
aPS HIV testing/rapid HIV test/not POC, comparing: #1 Current coverage at 5% #2 Scale up to reach coverage of 50% |
Kenya | General population (age not specified) | Health facility and community-based health services | 5 years | Modelling | Cost-effectiveness analysis and budget impact analysis | Published literature/data | Modelling |
| #13 (Mwenge et al., 2017) | HIV voluntary and provider-initiated counselling and testing/rapid HIV test/not POC | Malawi, Zambia and Zimbabwe | General population (aged 15–49 years) | Health facility | 1 year | Cross-sectional study | Cost analysis | Primary data collection | Econometric |
| #14 (Stuart et al., 2018) | HIV testing/type of test not specified/not POC | South Africa | General population (age not specified) | Not specified | 30 years | Modelling | Cost analysis | Published literature/data | Modelling |
| #15 (Tromp et al., 2013) |
HIV voluntary counselling and testing/HIV rapid test/not POC, comparing: #1 Current practice #2 Scaling up to reach coverage 80% |
Indonesia | Key populations (FSWs, IDUs, higher-risk MSM, transgender, prisoner, clients of FSWs and partner IDUs) (age not specified) | Community-based VCT clinic | 20 years | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #16 (Zhuang et al., 2018) |
HIV testing and treatment/type of test not specified/not POC, comparing: #1 Current strategy #2 Reached 90–90–90 target by 2020 # Reached 90–90–90 target by 2025 |
China | MSM (age not specified) | Health facility | 20 years | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #17 (Dandona et al., 2008a,b) | HIV counselling and testing/HIV rapid test/not POC | India | Pregnant women (age not specified) | Hospital and community health centre | 1 year | Cross-sectional study | Cost analysis | Primary data collection | Econometric |
| #18 (Dandona et al., 2005) | HIV counselling and testing/HIV rapid test/not POC | India | General population (age not specified) | VCT clinics | 1 year | Cross-sectional study | Cost analysis | Primary data collection | Econometric |
| #19 (Forsythe, 2002) | HIV voluntary counselling and testing/serial of HIV rapid testing/POC | Kenya | General population (age not specified) | Health facility | A year | Cross-sectional study | Cost analysis | Primary data collection | Empirical |
| #20 (Granich et al., 2009) |
HIV testing/type of test not specified/not POC, comparing: #1 Reference scenario #2 Universal voluntary HIV testing and immediate ART |
South Africa | General population (age not specified) | Not specified | 42 years | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #21 (Kasymova, Johns and Sharipova, 2009) | HIV testing and counselling/serial of HIV rapid test/not POC | Tajikistan |
Youth population (aged 15–25 years) |
Youth friendly health services | 2 years | Cross-sectional study | Cost analysis | Primary data collection | Modelling |
| #22 (Kato et al., 2013) |
HIV testing type of test not specified/not POC, comparing: #1 Reference scenario #2 Targeted PTIT scenario #3 Universal PTIT scenario |
Vietnam | Key population: PWID, MSM, FSWs, MCF, IDU and low-risk women (age not specified) | Health facility | 50 years | Modelling | Cost effectiveness analysis | Published literature/data | Modelling |
| #23 (Kumar et al., 2006) |
HIV testing and counselling/rapid HIV test/not POC, comparing: #1 A universal testing #2 A targeted testing |
India | Pregnant women (age not specified) | ANC clinic | Lifetime | Modelling | Cost–benefit analysis | Published literature/data | Modelling |
| #24 (Dandona et al., 2009) | HIV voluntary counselling and testing/HIV rapid test/not POC | India | General population (age not specified) | VCT clinic | 1 year | Cross-sectional study | Cost analysis | Primary data collection | Modelling |
| #25 (Mangenah et al., 2019) | HIVST/HIV rapid testing/not POC | Malawi, Zambia, and Zimbabwe | General population (aged 15–59 years) | Community based distributing agent | 1 year | Cross-sectional study | Cost analysis | Primary data collection | Econometric |
| #26 (McCreesh et al., 2017) |
HIV self-testing/HIV rapid test/not POC, comparing #1 Current coverage #2 Increased HIV testing (doubled) |
Uganda | General population (aged under 51 years) | Door-to-door community-based | 15 years | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #27 (Minh et al., 2012) | HIV voluntary counselling and testing/type of test not specified/not POC | Vietnam | General population (age not specified) | Facility based and freestanding VCT clinic | 4 months | Costing study | Cost analysis | Primary data collection | Modelling |
| #28 (Sharma et al., 2016) |
HIV home-based partner education and testing (HOPE)/HIV rapid test/not POC, comparing: #1 Standard care (facility-based HIV testing) #2 Adding HOPE to standard care |
Kenya | Partner of pregnant women (aged 0–59 years) | Home based | 10 years | Modelling alongside randomized controlled trial | Cost-effectiveness analysis | Primary data collection | Modelling |
| #29 (Nelwan et al., 2016) | HIV testing and counselling/HIV rapid test/not POC | Indonesia | Prisoner (age not specified) | Outpatient clinic in prison | 3 years | Case–control study | Cost analysis | Primary data collection | Modelling |
| #30 (Luong Nguyen et al., 2018) |
HIV voluntary counselling and testing/HIV rapid test/not POC, comparing: #1 Current testing coverage of 62% #2 Scale up testing coverage to 90% |
Kenya | General population (age not specified) | Health facility | 20 years | Modelling | Cost-effectiveness analysis and budget impact analysis | Published literature/data | Modelling |
| #31 (Rely, 2003) |
HIV counselling and testing/HIV rapid test/not POC, comparing: #1 Status quo (with 4% testing coverage) #2 Increase in coverage to 85% |
Mexico | Pregnant women (age not specified) | Health facility | Lifetime | Modelling | Cost-effectiveness analysis | Published literature/data | Modelling |
| #32 (Tchuenche et al., 2018) | VEID/DNA-PCR/not POC | Lesotho | HIV-exposed infants (0–2 weeks) | Health facility | 1 year | Retrospective observational study | Cost analysis | Primary data collection | Modelling |
| #33 (Verstraaten et al., 2017) | HIV voluntary counselling and testing/HIV rapid test/not POC | Indonesia | FSWs (age not specified) | Mobile VCT services | 1 year | Cost analysis | Primary data collection | Modelling | |
| #34 (Zang et al., 2016) |
HIV testing, comparing: #1 One4All (include testing, counselling, CD4 results, and viral load)/HIV rapid test/POC #2 Standard care/HIV rapid test+ western blot confirmatory test/POC |
China | General population (aged 15–64 years old) | Hospital | 1, 5 and 25 years | Modelling | Cost-effectiveness analysis alongside clustered randomized trial | Published literature/data | Modelling |
| #35 (Zhang et al., 2015) |
HIV testing/type of test not specified/not POC, comparing #1 Status quo #2 Reach universal coverage by 2015 #3 Reach universal coverage by 2017 #4 Reach universal coverage by 2022 |
Thailand | MSM (age not specified) | Health facility | 3-,5-and 10-years | Modelling | Cost-effectiveness analysis | Primary data collection | Modelling |
90–90–90 target: 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression. ANC, antenatal care; aPS, assisted partner service; ART, antiretroviral treatment; CD4, cluster of differentiation 4; DNA-PCR, deoxyribonucleic acid-polymerase chain reaction, a molecular diagnostic testing using DNA sequencing; HIVST, HIV self-testing; IDUs: injected drug users; MCF, male clients of female sex workers; POC: point-of-care; PTIT, HIV periodic testing and immediate treatment; PWID, people with injected drug; RPR, rapid plasma regain; VCT, HIV voluntary counselling and testing; VEID, very early infant diagnosis.