ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Cost-Effectiveness of Community-based Human Immunodeficiency Virus Self-Testing in Blantyre, Malawi.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Costs of HIV testing services in sub-Saharan Africa: a systematic literature review.BMC infectious diseases · 2024Pooled it
- Modelling Methods of Economic Evaluations of HIV Testing Strategies in Sub-Saharan Africa: A Systematic Review.Applied health economics and health policy · 2023Pooled it
- How much does HIV self-testing cost in low and middle income countries? A systematic review of evidence from economic studies.Frontiers in public health · 2023Pooled it
- The economic costs and cost-effectiveness of HIV self-testing among truck drivers in Kenya.Health policy and planning · 2024Trial
- Economic evaluation of facility-based HIV self-testing among adult outpatients in Malawi.Journal of the International AIDS Society · 2020Trial
- Trial
- Cost-Effectiveness of the I'm Ready HIV Self-Testing Programme Among High-Risk Populations in Canada.Journal of the International AIDS Society · 2026Article
- Self-care interventions for sexual and reproductive health: a strategic health systems investment.BMJ global health · 2025Review
- Costs and scale-up costs of community-based Oral HIV Self-Testing for female sex workers and men who have sex with men in Jakarta and Bali, Indonesia.BMC health services research · 2024Article
- A costing analysis of B-GAP: index-linked HIV testing for children and adolescents in Zimbabwe.BMC health services research · 2021Article
- Pragmatic economic evaluation of community-led delivery of HIV self-testing in Malawi.BMJ global health · 2021Article
- Comparison of index-linked HIV testing for children and adolescents in health facility and community settings in Zimbabwe: findings from the interventional B-GAP study.The lancet. HIV · 2021Article
- 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.Frontiers in public health · 2021Article
- Implementation outcomes of HIV self-testing in low- and middle- income countries: A scoping review.PloS one · 2021Article
- Using HIV self-testing to increase the affordability of community-based HIV testing services.AIDS (London, England) · 2020Article
- Correlates of HIV self-testing among female sex workers in China: implications for expanding HIV screening.Infectious diseases of poverty · 2020Article
- A novel method to estimate the indirect community benefit of HIV interventions using a microsimulation model of HIV disease.Journal of biomedical informatics · 2020Article
- Implementation of community and facility-based HIV self-testing under routine conditions in southern Eswatini.Tropical medicine & international health : TM & IH · 2020Article
- Costs of Providing HIV Self-Test Kits to Pregnant Women Living with HIV for Secondary Distribution to Male Partners in Uganda.Diagnostics (Basel, Switzerland) · 2020Article
- The Self-Testing AfRica (STAR) Initiative: accelerating global access and scale-up of HIV self-testing.Journal of the International AIDS Society · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
Abstract
Background: Human immunodeficiency virus self-testing (HIVST) is effective, with scale-up underway in sub-Saharan Africa. We assessed cost-effectiveness of adding HIVST to existing facility-based HIV testing and counseling (HTC) services. Both 2010 (initiate at CD4 <350 cells/μL) and 2015 (initiate all) World Health Organization (WHO) guidelines for antiretroviral treatment (ART) were considered. Methods: A microsimulation model was developed to evaluate cost-effectiveness, from both health provider and societal perspectives, of an HIVST service implemented in a cluster-randomized trial (CRT; ISRCTN02004005) in Malawi. Costs and health outcomes were evaluated over a 20-year time horizon, using a discount rate of 3%. Probabilistic sensitivity analysis was conducted to account for parameter uncertainty. Results: From the health provider perspective and 20-year time horizon, facility HTC using 2010 WHO ART guidelines was the least costly ($294.71 per person; 95% credible interval [CrI], 270.79-318.45) and least effective (11.64 quality-adjusted life-years [QALYs] per person; 95% CrI, 11.43-11.86) strategy. Compared with this strategy, the incremental cost-effectiveness ratio (ICER) for facility HTC using 2015 WHO ART guidelines was $226.85 (95% CrI, 198.79-284.35) per QALY gained. The strategy of facility HTC plus HIVST, using 2010 WHO ART guidelines, was extendedly dominated. The ICER for facility HTC plus HIVST, using 2015 WHO ART guidelines, was $253.90 (95% CrI, 201.71-342.02) per QALY gained compared with facility HTC and using 2015 WHO ART guidelines. Conclusions: HIVST may be cost-effective in a Malawian population with high HIV prevalence. HIVST is suited to an early HIV diagnosis and treatment strategy. Clinical Trials registration: ISRCTN02004005.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.