Evaluation of Community-Based, Mobile HIV-Care, Peer-Delivered Linkage Case Management in Manzini Region, Eswatini

Chutima Suraratdecha (), Duncan MacKellar, Thabo Hlophe, Makhosazana Dlamini, Dawud Ujamaa, Sherri Pals, Lenhle Dube, Daniel Williams, Johnita Byrd, Phumzile Mndzebele, Stephanie Behel, Ishani Pathmanathan, Sikhathele Mazibuko, Endale Tilahun and Caroline Ryan
Additional contact information
Chutima Suraratdecha: Division of Global HIV and TB, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
Duncan MacKellar: Division of Global HIV and TB, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
Thabo Hlophe: Eswatini Ministry of Health, Mbabane P.O. Box 5, Eswatini
Makhosazana Dlamini: Population Services International, Mbabane P.O. Box 170, Eswatini
Dawud Ujamaa: ICF International, Atlanta, GA 30345, USA
Sherri Pals: Division of Global HIV and TB, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
Lenhle Dube: Eswatini Ministry of Health, Mbabane P.O. Box 5, Eswatini
Daniel Williams: U.S. Centers for Disease Control and Prevention, Pretoria P.O. Box 9536, South Africa
Johnita Byrd: ICF International, Atlanta, GA 30345, USA
Phumzile Mndzebele: U.S. Centers for Disease Control and Prevention, Mbabane P.O. Box D202, Eswatini
Stephanie Behel: Division of Global HIV and TB, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
Ishani Pathmanathan: Division of Global HIV and TB, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
Sikhathele Mazibuko: U.S. Centers for Disease Control and Prevention, Mbabane P.O. Box D202, Eswatini
Endale Tilahun: Population Services International, Mbabane P.O. Box 170, Eswatini
Caroline Ryan: U.S. Centers for Disease Control and Prevention, Mbabane P.O. Box D202, Eswatini

IJERPH, 2022, vol. 20, issue 1, 1-9

Abstract: The success of antiretroviral therapy (ART) requires continuous engagement in care and optimal levels of adherence to achieve sustained HIV viral suppression. We evaluated HIV-care cascade costs and outcomes of a community-based, mobile HIV-care, peer-delivered linkage case-management program (CommLink) implemented in Manzini region, Eswatini. Abstraction teams visited referral facilities during July 2019–April 2020 to locate, match, and abstract the clinical data of CommLink clients diagnosed between March 2016 and March 2018. An ingredients-based costing approach was used to assess economic costs associated with CommLink. The estimated total CommLink costs were $2 million. Personnel costs were the dominant component, followed by travel, commodities and supplies, and training. Costs per client tested positive were $499. Costs per client initiated on ART within 7, 30, and 90 days of diagnosis were $2114, $1634, and $1480, respectively. Costs per client initiated and retained on ART 6, 12, and 18 months after diagnosis were $2343, $2378, and $2462, respectively. CommLink outcomes and costs can help inform community-based HIV testing, linkage, and retention programs in other settings to strengthen effectiveness and improve efficiency.

Keywords: community-based HIV services; linkage to care; retention to ART; cost; cost-outcome; Eswatini (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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