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

Marc d’Elbée, Métogara Traore, Kéba Badiane, Anthony Vautier, Arlette Fotso (), Odé Kanku Kabemba, Nicolas Rouveau, Peter Godfrey-Faussett, Mathieu Maheu-Giroux, Marie-Claude Boily, Graham Medley, Joseph Larmarange () and Fern Terris-Prestholt Terris-Prestholt ()
Additional contact information
Marc d’Elbée: LSHTM - London School of Hygiene and Tropical Medicine
Métogara 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 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 Medley: LSHTM - London School of Hygiene and Tropical Medicine
Joseph Larmarange: 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, CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UPCité - Université Paris Cité
Fern Terris-Prestholt Terris-Prestholt: LSHTM - London School of Hygiene and Tropical Medicine, ONUSIDA - UNAIDS [Genève, Suisse]

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Abstract: BACKGROUND: 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 the 90-90-90 targets. Key populations including female sex workers (FSW), men who have sex with men (MSM), and people who use drugs (PWUD) are the most vulnerable groups with HIV prevalence at 5%-30%. HIV self-testing (HIVST) was introduced in West Africa in 2019 as a new testing modality through the ATLAS project coordinated by the international partner organisation Solthis (IPO). METHODS: We estimated the costs of implementing HIVST through twenty-three civil society organisations (CSO)-led models 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). RESULTS: 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. Cost per HIVST kit distributed ranged from $12-$15 (FSW), $14-$27 (MSM), to $15-$143 (PWUD), driven by personnel costs at various intervention levels (53%-78% of total costs), and HIVST kit costs (2%-15%). Predicted costs at scale-up ranged from $5-$13 (FSW), $5-$24 (MSM), to $13-$53 (PWUD), and were mainly explained by the spreading of IPO costs over higher HIVST distribution volumes. CONCLUSIONS: In all countries, CSO-led HIVST kit provision to key populations showed relatively high costs related to the progressive integration of the programme to CSO activities and contextual challenges (e.g. country security issues). In the transition to scale-up and further integration of the HIVST programme into CSO activities, this model can become less costly. This is particularly relevant as it remains today the most promising strategy for reaching key populations and their sexual partners not accessing HIV testing.

Date: 2021-07
New Economics Papers: this item is included in nep-inv
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Published in 11th IAS Conference on HIV Science (IAS 2021), Jul 2021, Berlin, Germany

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