• Article

Assessment of the potential impact and cost-effectiveness of self-testing for HIV in low-income countries

BACKGROUND: Studies have demonstrated that self-testing for human immunodeficiency virus (HIV) is highly acceptable among individuals and could allow cost savings, compared with provider-delivered HIV testing and counseling (PHTC), although the longer-term population-level effects are uncertain. We evaluated the cost-effectiveness of introducing self-testing in 2015 over a 20-year time frame in a country such as Zimbabwe. METHODS: The HIV synthesis model was used. Two scenarios were considered. In the reference scenario, self-testing is not available, and the rate of first-time and repeat PHTC is assumed to increase from 2015 onward, in line with past trends. In the intervention scenario, self-testing is introduced at a unit cost of $3. RESULTS: We predict that the introduction of self-testing would lead to modest savings in healthcare costs of $75 million, while averting around 7000 disability-adjusted life-years over 20 years. Findings were robust to most variations in assumptions; however, higher cost of self-testing, lower linkage to care for people whose diagnosis is a consequence of a positive self-test result, and lower threshold for antiretroviral therapy eligibility criteria could lead to situations in which self-testing is not cost-effective. CONCLUSIONS: This analysis suggests that introducing self-testing offers some health benefits and may well save costs

Citation

Cambiano, V., Ford, D., Mabugu, T., Napierala Mavedzenge, S., Miners, A., Mugurungi, O., ... Phillips, A. (2015). Assessment of the potential impact and cost-effectiveness of self-testing for HIV in low-income countries. Journal of Infectious Diseases, 212(4), 570-577. DOI: 10.1093/infdis/jiv040

DOI Links