The Cost-Effectiveness of Integrating HIV Counseling and Testing into Primary Health Care in the Ukraine

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• 作者：Benjamin Johns ; Olena Doroshenko ; Lisa Tarantino ; Peter Cowley
• 关键词：HIV counseling and testing ; Ukraine ; Integration ; Primary health care ; Cost ; effectiveness
• 刊名：AIDS and Behavior
• 出版年：2017
• 出版时间：March 2017
• 年：2017
• 卷：21
• 期：3
• 页码：655-664
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Public Health; Health Psychology; Infectious Diseases;
• 出版者：Springer US
• ISSN：1573-3254
• 卷排序：21

文摘

We estimate the number of HIV cases diagnosed, costs, and cost per HIV case detected associated with integrating HIV counseling and testing (HCT) into primary health care facilities in Ukraine. The study uses a difference-in-difference design with four districts implementing the intervention compared to 20 districts where HCT were offered only at specialized HIV clinics. There was a 2.01 (95 % CI: 1.12–3.61) times increase in the number of HIV cases detected per capita in intervention districts compared to other districts. The incremental cost of the intervention was $21,017 and the incremental cost per HIV case detected was $369. The average cost per HIV case detected before the intervention was $558. Engaging primary health care facilities to provide HCT is likely desirable from an efficiency point-of-view. However, the affordability of the intervention needs to be assessed because expansion will require additional investment.