ArticleInternational journal of epidemiology2019
HIV testing and counselling couples together for affordable HIV prevention in Africa.
Article in International journal of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 5 of them syntheses that pooled it.
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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.
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Who cites it
20 citing papers in PubMed, 5 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Health technology assessment to support health benefits package design: a systematic review of economic evaluation evidence in Zambia.BMC health services research · 2024Pooled it
- Reproductive health needs of HIV serodiscordant couples: a systematic review.Frontiers in public health · 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
- Strategies to increase couples HIV testing and counselling in sub-Saharan Africa: a systematic review.Journal of the International AIDS Society · 2023Pooled it
- A Systematic Review of HIV Testing Implementation Strategies in Sub-Saharan African Countries.AIDS and behavior · 2022Pooled it
- Cost-Effectiveness of Linkage Case Management for Hospitalized People With HIV.JAMA network open · 2025Trial
- Behavioral Modeling and its Association with PrEP and ART Use in Ugandan HIV-Serodifferent Couples.AIDS and behavior · 2024Trial
- Use of "Strengthening Our Vows" Video Intervention to Encourage Negotiated Explicit Sexual Agreements in Zambian Heterosexual HIV Seroconcordant-Negative Couples.Archives of sexual behavior · 2023Trial
- Facilitators and barriers to community-based HIV testing in Guinea: a CFIR-based implementation analysis.Frontiers in public health · 2025Article
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- Psychosocial support for HIV serodiscordant couples.Health psychology and behavioral medicine · 2022Article
- A cluster randomized trial to reduce HIV risk from outside partnerships in Zambian HIV-Negative couples using a novel behavioral intervention, "Strengthening Our Vows": Study protocol and baseline data.Contemporary clinical trials communications · 2021Article
- Cohort Profile: IAVI's HIV epidemiology and early infection cohort studies in Africa to support vaccine discovery.International journal of epidemiology · 2021Article
- Increased Frequency of Inter-Subtype HIV-1 Recombinants Identified by Near Full-Length Virus Sequencing in Rwandan Acute Transmission Cohorts.Frontiers in microbiology · 2021Article
- Cost-effectiveness of integrated HIV prevention and family planning services for Zambian couples.AIDS (London, England) · 2020Article
- Cost-effectiveness of couples' voluntary HIV counselling and testing in six African countries: a modelling study guided by an HIV prevention cascade framework.Journal of the International AIDS Society · 2020Article
- Motivational interviewing to promote long-acting reversible contraception among Rwandan couples wishing to prevent or delay pregnancy.American journal of obstetrics and gynecology · 2020Article
- A couple-focused, integrated unplanned pregnancy and HIV prevention program in urban and rural Zambia.American journal of obstetrics and gynecology · 2020Article
- Cost-effectiveness of HIV Prevention Interventions in Sub-Saharan Africa: A Systematic Review.EClinicalMedicine · 2019Article
Corrections and comments
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Authors and funding
16 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundThe impact and cost-effectiveness of couples' voluntary HIV counselling and testing (CVCT) has not been quantified in real-world settings. We quantify cost-per-HIV-infection averted by CVCT in Zambia from the donor's perspective.
methodsFrom 2010 to 2016, CVCT was established in 73 Zambian government clinics. The cost-per-HIV-infection averted (CHIA) of CVCT was calculated using observed expenditures and effectiveness over longitudinal follow-up. These observed measures parameterized hypothetical 5-year nationwide implementations of: 'CVCT'; 'treatment-as-prevention (TasP) for discordant couples' identified by CVCT; and 'population TasP' for all HIV+ cohabiting persons identified by individual testing.
resultsIn all, 207 428 couples were tested (US $52/couple). Among discordant couples in which HIV+ partners self-reported antiretroviral therapy (ART), HIV incidence was 8.5/100 person-years before and 1.8/100 person-years after CVCT (79% reduction). Corresponding reductions for non-ART-using discordant and concordant negative couples were 63% and 47%, respectively. CVCT averted an estimated 58% of new infections at US $659 CHIA. In nationwide implementation models, CVCT would prevent 17 times the number of infections vs 'TasP for discordant couples' at 86% of the cost, and nine times the infections vs 'population TasP' at 28% of the cost.
conclusionsCVCT is a cost-effective, feasible prevention strategy in Zambia. We demonstrate the novel, added effectiveness of providing CVCT to ART users, for whom ART use alone only partially mitigated transmission risk. Our results indicate a major policy shift (supporting development of CVCT indicators, budgets and targets) and have clinical implications (suggesting promotion of CVCT in ART clinics as a high-impact prevention strategy).
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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.