BibTex format
@article{Lu:2024:10.1002/jia2.26334,
author = {Lu, IJ and Silhol, R and d'Elbée, M and Boily, M-C and Soni, N and Ky-Zerbo, O and Vautier, A and Simo, Fosto A and Badiane, K and Traoré, M and Terris-Prestholt, F and Larmarange, J and Maheu-Giroux, M and ATLAS, Team},
doi = {10.1002/jia2.26334},
journal = {Journal of the International AIDS Society},
title = {Cost-effectiveness analysis of community-led HIV self-testing among key populations in Côte d'Ivoire, Mali, and Senegal},
url = {http://dx.doi.org/10.1002/jia2.26334},
volume = {27},
year = {2024}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - INTRODUCTION: HIV self-testing (HIVST) is a promising strategy to improve diagnosis coverage among key populations (KP). The ATLAS (Auto Test VIH, Libre d'Accéder à la connaissance de son Statut) programme implemented HIVST in three West African countries, distributing over 380,000 kits up between 2019 and 2021, focussing on community-led distribution by KP to their peers and subsequent secondary distribution to their partners and clients. We aim to evaluate the cost-effectiveness of community-led HIVST in Côte d'Ivoire, Mali and Senegal. METHODS: An HIV transmission dynamics model was adapted and calibrated to country-specific epidemiological data and used to predict the impact of HIVST. We considered the distribution of HIVST among two KP-female sex workers (FSW), and men who have sex with men (MSM)-and their sexual partners and clients. We compared the cost-effectiveness of two scenarios against a counterfactual without HIVST over a 20-year horizon (2019-2039). The ATLAS-only scenario mimicked the 2-year implemented ATLAS programme, whereas the ATLAS-scale-up scenario achieved 95% coverage of HIVST distribution among FSW and MSM by 2025 onwards. The primary outcome is the number of disability-adjusted life-years (DALY) averted. Scenarios were compared using incremental cost-effectiveness ratios (ICERs). Costing was performed using a healthcare provider's perspective. Costs were discounted at 4%, converted to $USD 2022 and estimated using a cost-function to accommodate economies of scale. RESULTS: The ATLAS-only scenario was highly cost-effective over 20 years, even at low willingness-to-pay thresholds. The median ICERs were $126 ($88-$210) per DALY averted in Côte d'Ivoire, $92 ($88-$210) in Mali and 27$ ($88-$210) in Senegal. Scaling-up the ATLAS programme would also be cost-effective, and substantial epidemiological impacts would be achieved. The ICERs for the scale-up scenario were $199 ($122-$338) per DALY averted in Côte d'Ivo
AU - Lu,IJ
AU - Silhol,R
AU - d'Elbée,M
AU - Boily,M-C
AU - Soni,N
AU - Ky-Zerbo,O
AU - Vautier,A
AU - Simo,Fosto A
AU - Badiane,K
AU - Traoré,M
AU - Terris-Prestholt,F
AU - Larmarange,J
AU - Maheu-Giroux,M
AU - ATLAS,Team
DO - 10.1002/jia2.26334
PY - 2024///
SN - 1758-2652
TI - Cost-effectiveness analysis of community-led HIV self-testing among key populations in Côte d'Ivoire, Mali, and Senegal
T2 - Journal of the International AIDS Society
UR - http://dx.doi.org/10.1002/jia2.26334
UR - https://www.ncbi.nlm.nih.gov/pubmed/39034541
UR - https://onlinelibrary.wiley.com/doi/10.1002/jia2.26334
UR - http://hdl.handle.net/10044/1/114285
VL - 27
ER -