Skip to main content

Advertisement

Log in

Cost of Community-Based HIV Testing Activities to Reach Saturation in Botswana

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

In Botswana, 85% of persons living with HIV are aware of their status. We performed an economic analysis of HIV testing activities implemented during intensive campaigns, in 11 communities, between April 2015 and March 2016, through the Botswana Combination Prevention Project. The total cost was $1,098,312, or $99,847 per community, with 60% attributable to home-based testing and 40% attributable to mobile testing. The cost per person tested was $44, and $671 per person testing positive (2017 USD). Labor costs comprised 64% of total costs. In areas of high HIV prevalence and treatment coverage, the cost of untargeted home-based testing may be inflated by the efforts required to assess the testing eligibility of clients who are HIV-positive and on ART. Home-based and mobile testing delivered though an intensive community-based campaign allowed the identification of HIV positive persons, who may not access health facilities, at a cost comparable to other studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. UNAIDS. Botswana Country fact sheet. http://www.unaids.org/en/regionscountries/countries/botswana (2017). Accessed 18 Feb 2018

  2. Botswana Ministry of Health. Handbook of the Botswana 2016 Integrated HIV Clinical Care guidelines. Botswana: Gaborone; 2016.

    Google Scholar 

  3. Gaolathe T, Wirth KE, Holme MP, Makhema J, Moyo S, Chakalisa U, et al. Botswana’s progress toward achieving the 2020 UNAIDS 90–90–90 antiretroviral treatment and virologic suppression goals: results of a population-based survey. Lancet HIV. 2016;3(5):e221–30.

    Article  PubMed  PubMed Central  Google Scholar 

  4. UNAIDS. Ending AIDS: progress towards the 90-90-90 targets. Geneva, Switzerland: UNAIDS; 2017.

  5. Chang W, Chamie G, Mwai D, Clark TD, Thirumurthy H, Charlebois ED, et al. Implementation and operational research: cost and efficiency of a hybrid mobile multidisease testing approach with high HIV testing coverage in East Africa. J Acquir Immune Defic Syndr. 2016;73(3):e39–45.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sharma M, Ying R, Tarr G, Barnabas R. Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa. Nature. 2015;528(7580):S77–85.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Tabana H, Nkonki L, Hongoro C, Doherty T, Ekstrom AM, Naik R, et al. A cost-effectiveness analysis of a home-based HIV counselling and testing intervention versus the standard (facility based) HIV testing strategy in rural South Africa. PLoS ONE. 2015;10(8):e0135048.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Meehan S-A, Beyers N, Burger R. Cost analysis of two community-based HIV testing service modalities led by a non-governmental organization in Cape Town, South Africa. BMC Health Serv Res. 2017;17:801.

    Article  PubMed  PubMed Central  Google Scholar 

  9. de Beer I, Chani K, Feeley FG, de Wit TFR, Sweeney-Bindels E, Mulongeni P. Assessing the costs of mobile voluntary counseling and testing at the work place versus facility based voluntary counseling and testing in Namibia. Rural Remote Health. 2015;15(4):3357.

    PubMed  Google Scholar 

  10. Country income levels [Internet]. http://data.worldbank.org/country. Accessed 2 Sept 2016.

  11. Table 1.1.9. Implicit price deflators for gross domestic product [Internet]. https://www.bea.gov/iTable/iTable.cfm?reqid=9&step=3&isuri=1&903=13#reqid=9&step=3&isuri=1&903=13 Accessed 2 Sept 2016.

  12. Aliyu HB, Chuku NN, Kola-Jebutu A, Abubakar Z, Torpey K, Chabikuli ON. What is the cost of providing outpatient HIV counseling and testing and antiretroviral therapy services in selected public health facilities in Nigeria? J Acquir Immune Defic Syndr. 2012;61(2):221–5.

    Article  PubMed  Google Scholar 

  13. Bassett IV, Giddy J, Nkera J, Wang B, Losina E, Lu Z, et al. Routine voluntary HIV testing in Durban, South Africa: the experience from an outpatient department. J Acquir Immune Defic Syndr. 2007;46(2):181–6.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bautista-Arredondo S, Sosa-Rubi SG, Opuni M, Contreras-Loya D, Kwan A, Chaumont C, et al. Costs along the HTC and PMTCT service cascades: findings from Kenya, South Africa, and Zambia. Rwanda: Aids; 2016.

    Google Scholar 

  15. World Health Organization. Consolidated guidelines on HIV testing services: 5Cs: consent, confidentiality, counselling, correct results and connection. Geneva: WHO; 2015.

  16. Johnson C, Dalal S, Baggaley R, Hogan D, Parrott G, Mathews R, et al. Systematic review of HIV testing costs in high and low income settings. Consolidated guidelines on HIV testing services: 5Cs: consent, confidentiality, counselling, correct results and connection. ANNEX 5. Geneva: World Health Organization; 2015.

Download references

Disclaimer

The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the official position of the funding agencies.

Funding

This project has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of Cooperative Agreements U2G GH000073 and U2G GH000419.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Arielle Lasry.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

The Botswana Combination Prevention Project study was approved by the Centers for Disease Control and Prevention Institutional Review Board (Protocol #6475) and the Botswana Health Research and Development Committee (HRDC; Institutional Review Board of the Botswana Ministry of Health and Wellness).

Informed Consent

Informed consent was obtained from all individual participants included in the Botswana Combination Prevention Project.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 15 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lasry, A., Bachanas, P., Suraratdecha, C. et al. Cost of Community-Based HIV Testing Activities to Reach Saturation in Botswana. AIDS Behav 23, 875–882 (2019). https://doi.org/10.1007/s10461-019-02408-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-019-02408-9

Keywords

Navigation