title: Cost effectiveness of couple counselling to enhance infant HIV-1 prevention.
abstract: Data collected in the years 2001--2003 from an antenatal clinic in Nairobi, Kenya, were used to assess the benefit of couple counselling and test it as a way of increasing the uptake of interventions in the prevention of mother-to-child transmission of HIV-1. Among 2833 women enrolled, 311 (11%) received couple pretest counselling and 2100 (74%) accepted HIV-1 testing. Among those tested 314 (15%) were HIV-1 seropositive. We incorporated these and other data from the cohort study into a spreadsheet-based model and costs associated with couple counselling were compared with individual counselling in a theoretical cohort of 10,000 women. Voluntary couple counselling and testing (VCT), although more expensive, averted a greater number of infant infections when compared with individual VCT. Cost per disability-adjusted life year was similar to that of individual VCT. Sensitivity analyses found that couple VCT was more cost-effective in scenarios with increased uptake of couple counselling and higher HIV-1 prevalence.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya. fnjiri@csrtkenya.org
authors.forename: Francis N
authors.initials: FN
authors.lastname: John
authors.forename: Carey
authors.initials: C
authors.lastname: Farquhar
authors.forename: James N
authors.initials: JN
authors.lastname: Kiarie
authors.forename: Marjory N
authors.initials: MN
authors.lastname: Kabura
authors.forename: Grace C
authors.initials: GC
authors.lastname: John-Stewart
mesh_terms: D015492:AIDS Serodiagnosis / Q000191:economics*; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000191:economics; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics*; D015658:HIV Infections / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D015528:HIV Seroprevalence; D015497:HIV-1; D006266:Health Education; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000191:economics / Q000517:prevention & control*
chemical_list: D019380:Anti-HIV Agents