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Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali

Author

Listed:
  • Marc d'Elbée

    (LSHTM - London School of Hygiene and Tropical Medicine)

  • Métogara Mohamed Traore

    (SOLTHIS - Solidarité thérapeutique & initiatives contre le sida)

  • Kéba Badiane

    (SOLTHIS - Solidarité thérapeutique & initiatives contre le sida)

  • Anthony Vautier

    (SOLTHIS - Solidarité thérapeutique & initiatives contre le sida)

  • Arlette Simo Fotso

    (CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UPCité - Université Paris Cité, SAGESUD - ERL Inserm U1244 - Santé, vulnérabilités et relations de genre au sud - INSERM - Institut National de la Santé et de la Recherche Médicale - CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UPCité - Université Paris Cité)

  • Odé Kanku Kabemba

    (SOLTHIS - Solidarité thérapeutique & initiatives contre le sida)

  • Nicolas Rouveau

    (CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UPCité - Université Paris Cité, SAGESUD - ERL Inserm U1244 - Santé, vulnérabilités et relations de genre au sud - INSERM - Institut National de la Santé et de la Recherche Médicale - CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UPCité - Université Paris Cité)

  • Peter Godfrey-Faussett

    (ONUSIDA - UNAIDS [Genève, Suisse], LSHTM - London School of Hygiene and Tropical Medicine)

  • Mathieu Maheu-Giroux

    (McGill University = Université McGill [Montréal, Canada])

  • Marie-Claude Boily

    (Imperial College London)

  • Graham Francis Medley

    (LSHTM - London School of Hygiene and Tropical Medicine)

  • Joseph Larmarange

    (CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UPCité - Université Paris Cité, SAGESUD - ERL Inserm U1244 - Santé, vulnérabilités et relations de genre au sud - INSERM - Institut National de la Santé et de la Recherche Médicale - CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UPCité - Université Paris Cité)

  • Fern Terris-Prestholt

    (LSHTM - London School of Hygiene and Tropical Medicine)

Abstract

Despite significant progress on the proportion of individuals who know their HIV status in 2020, Côte d'Ivoire (76%), Senegal (78%), and Mali (48%) remain far below, and key populations (KP) including female sex workers (FSW), men who have sex with men (MSM), and people who use drugs (PWUD) are the most vulnerable groups with a HIV prevalence at 5–30%. HIV self-testing (HIVST), a process where a person collects his/her own specimen, performs a test, and interprets the result, was introduced in 2019 as a new testing modality through the ATLAS project coordinated by the international partner organisation Solthis (IPO). We estimate the costs of implementing HIVST through 23 civil society organisations (CSO)-led models for KP in Côte d'Ivoire (N = 7), Senegal (N = 11), and Mali (N = 5). We modelled costs for programme transition (2021) and early scale-up (2022–2023). Between July 2019 and September 2020, a total of 51,028, 14,472, and 34,353 HIVST kits were distributed in Côte d'Ivoire, Senegal, and Mali, respectively. Across countries, 64–80% of HIVST kits were distributed to FSW, 20–31% to MSM, and 5–8% to PWUD. Average costs per HIVST kit distributed were $15 for FSW (Côte d'Ivoire: $13, Senegal: $17, Mali: $16), $23 for MSM (Côte d'Ivoire: $15, Senegal: $27, Mali: $28), and $80 for PWUD (Côte d'Ivoire: $16, Senegal: $144), driven by personnel costs (47–78% of total costs), and HIVST kits costs (2–20%). Average costs at scale-up were $11 for FSW (Côte d'Ivoire: $9, Senegal: $13, Mali: $10), $16 for MSM (Côte d'Ivoire: $9, Senegal: $23, Mali: $17), and $32 for PWUD (Côte d'Ivoire: $14, Senegal: $50). Cost reductions were mainly explained by the spreading of IPO costs over higher HIVST distribution volumes and progressive IPO withdrawal at scale-up. In all countries, CSO-led HIVST kit provision to KP showed relatively high costs during the study period related to the progressive integration of the programme to CSO activities and contextual challenges (COVID-19 pandemic, country safety concerns). In transition to scale-up and integration of the HIVST programme into CSO activities, this model shows large potential for substantial economies of scale. Further research will assess the overall cost-effectiveness of this model.

Suggested Citation

  • Marc d'Elbée & Métogara Mohamed Traore & Kéba Badiane & Anthony Vautier & Arlette Simo Fotso & Odé Kanku Kabemba & Nicolas Rouveau & Peter Godfrey-Faussett & Mathieu Maheu-Giroux & Marie-Claude Boily , 2021. "Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali," Post-Print ird-03883601, HAL.
  • Handle: RePEc:hal:journl:ird-03883601
    DOI: 10.3389/fpubh.2021.653612
    Note: View the original document on HAL open archive server: https://ird.hal.science/ird-03883601
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    References listed on IDEAS

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    1. Monisha Sharma & Roger Ying & Gillian Tarr & Ruanne Barnabas, 2015. "Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa," Nature, Nature, vol. 528(7580), pages 77-85, December.
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