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Economic costs and health-related quality of life outcomes of HIV treatment after self- and facility-based HIV testing in a cluster randomized trial

Maheswaran et al.

Publication year


Type of approach

Type of assistance


Study population
People living with HIV: People living with HIV

Study design
Resource use

Sample size

UNAIDS HIV prevalence (2017)
9.1 [8.4 - 9.9]

Data are from a midpoint survey of a randomized controlled trial, consisting of 325 participants attending HIV clinics for antiretroviral treatment assessment. Health-care resource use was prospectively measured, and primary costing studies undertaken to estimate total health provider costs. Participants were interviewed to establish direct non-medical and indirect costs over the first year of treatment. Multivariable analyses estimated predictors of economic outcomes. Study period: March 2013-January 2015.

Summary of findings
Of 325 participants attending HIV clinics for assessment for antiretroviral therapy (ART), 265 were identified through facility-based HIV testing and counselling services (HTC), and 60 through HIVST; 168/265 (69.2%) and 36/60 (60.0%), respectively, met national ART eligibility criteria and initiated treatment. The mean total health provider assessment costs for ART initiation were US$22.79 (SE: 0.56) and US$19.92 (SE: 0.77) for facility-based HTC and HIVST participants, respectively, and was US$2.87 (bootstrap 95% CI: US$1.01 to US$4.73) lower for the HIVST group. The mean total health provider costs for the first year of ART were US$168.65 (SE: 2.02) and US$164.66 (SE: 4.21) for facility-based HTC and HIVST participants, respectively, and comparable between the 2 groups (bootstrap 95% CI: 2US$12.38 to US$4.39).


Acceptability details

Willingness to pay

Willingness to pay details




HIV positivity
100% (325/325)

Accuracy details

Social harm

Linkage to prevention, care and treatment

Study status

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