Evidence map›Paper›PMID 38026397›Full record

SynthesisFrontiers in public health2023

How much does HIV self-testing cost in low and middle income countries? A systematic review of evidence from economic studies.

Brianna Empringham, Angela Karellis, Abdulhameed Kashkary, Olivia D'Silva, Sergio Carmona, Marta Fernandez Suarez, Angelina Addae, Nitika Pant Pai, Alice Anne Zwerling

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Frontiers in public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. HIV Self-Test Experiences and Implementation Considerations Among Transgender Women in the Philippines: Getting Ready for Scale-Up.AIDS education and prevention : official publication of the International Society for AIDS Education · 2025
    Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Brianna EmpringhamSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Angela KarellisDivision of Clinical Epidemiology & Experimental Medicine, McGill University, Montreal, QC, Canada.
Abdulhameed KashkarySchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Olivia D'SilvaSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Sergio CarmonaFoundation for Innovative New Diagnostics, Geneva, Switzerland.
Marta Fernandez SuarezFoundation for Innovative New Diagnostics, Geneva, Switzerland.
Angelina AddaeSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Nitika Pant PaiDivision of Clinical Epidemiology & Experimental Medicine, McGill University, Montreal, QC, Canada.
Alice Anne ZwerlingSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
University of Ottawa · CAFoundation for Innovative New Diagnostics · CHMcGill University · CAChildren's Hospital of Eastern Ontario · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: HIV self-testing (HIVST) has been proposed as an innovative strategy to diagnose human immunodeficiency virus (HIV). While HIVST offers the potential to broaden accessibility of early HIV diagnosis and treatment initiation, this testing strategy incurs additional cost and requires confirmatory testing and treatment. We have conducted the first systematic review to summarize the current economic literature for HIVST in low- and middle-income countries (LMICs). Design: A search strategy was developed including key terms for HIV, self-testing and cost-effectiveness and was conducted in Medline and Embase databases. Studies were included that reported costs per outcome and included both cost-effectiveness and cost-utility outcome measures. The search strategy identified publications up until August 15, 2023 were included. Abstract and full text screening was conducted and a standardized data abstraction form was used for included studies. Costs are reported in USD, 2020. Results: Our search strategy identified 536 total titles from the search strategy, which were screened down to 25 relevant studies that provided both cost and outcome data on HIVST. There was significant heterogeneity in the HIVST intervention, study population, costs and outcomes reported among included studies. Cost per person tested ranged from $1.09-155. Cost per case diagnosed ranged from $20-1,277. Cost-utility estimates ranged from cost-saving to $1846 per DALY averted. Higher cost-effectiveness estimates were associated with more expensive testing algorithms with increased support for linkage to care and post-test counseling. Conclusion: All studies considered HIVST cost-effective although major drivers were identified included underlying HIV prevalence, testing cost and linkage to care. HIVST is likely to be cost-effective in a LMIC context, however policy makers should be aware of the drivers of cost-effectiveness when implementing HIVST programs as these underlying factors can impact the overall cost-effectiveness of HIVST.

Indexed as

HIVHIV InfectionsDeveloping CountriesHumansMass ScreeningSelf-Testingcost effectivenesshealth systemsHIV epidemiologysystematic reviewtesting

Identifiers

PMID38026397
PMCPMC10679730
OpenAlexW4388646240

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.