title: The Cost-Effectiveness of Integrating HIV Counseling and Testing into Primary Health Care in the Ukraine.
abstract: We estimate the number of HIV cases diagnosed, costs, and cost per HIV case detected associated with integrating HIV counseling and testing (HCT) into primary health care facilities in Ukraine. The study uses a difference-in-difference design with four districts implementing the intervention compared to 20 districts where HCT were offered only at specialized HIV clinics. There was a 2.01 (95 % CI: 1.12-3.61) times increase in the number of HIV cases detected per capita in intervention districts compared to other districts. The incremental cost of the intervention was $21,017 and the incremental cost per HIV case detected was $369. The average cost per HIV case detected before the intervention was $558. Engaging primary health care facilities to provide HCT is likely desirable from an efficiency point-of-view. However, the affordability of the intervention needs to be assessed because expansion will require additional investment.
authors.affiliation: International Health Division, Abt Associates, Inc., 4550 Montgomery Avenue, Bethesda, MD, 20814, USA. ben_johns@abtassoc.com.
authors.forename: Benjamin
authors.identifier: http://orcid.org/0000-0002-2892-6089
authors.initials: B
authors.lastname: Johns
authors.affiliation: Ukraine Country Office, The World Bank, Kyiv, Ukraine.
authors.forename: Olena
authors.initials: O
authors.lastname: Doroshenko
authors.affiliation: International Health Division, Abt Associates, Inc., 4550 Montgomery Avenue, Bethesda, MD, 20814, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Tarantino
authors.affiliation: International Health Division, Abt Associates, Inc., 4550 Montgomery Avenue, Bethesda, MD, 20814, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Cowley
mesh_terms: D015492:AIDS Serodiagnosis; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics* / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000191:economics* / Q000379:methods; D015658:HIV Infections / Q000175:diagnosis / Q000191:economics* / Q000517:prevention & control; D006801:Humans; D008403:Mass Screening / Q000191:economics* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration*; D014455:Ukraine
keywords: Cost-effectiveness; HIV counseling and testing; Integration; Primary health care; Ukraine