The impact and cost‐effectiveness of community‐based HIV self‐testing in sub‐Saharan Africa: a health economic and modelling analysis

The prevalence of undiagnosed HIV is declining in Africa, and various HIV testing approaches are finding lower positivity rates. In this context, the epidemiological impact and cost‐effectiveness of community‐based HIV self‐testing (CB‐HIVST) is unclear. We aimed to assess this in different sub‐populations and across scenarios characterized by different adult HIV prevalence and antiretroviral treatment programmes in sub‐Saharan Africa.

• Publication year

  2019

• Venue

  Journal of the International AIDS Society

• Publication date

  2019-03-01

• Fields of study

  Medicine, Economics

• Identifiers
  DOI 10.1002/jia2.25243PMID 30907498PMCID 6432108
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• The impact and cost‐effectiveness of community‐based HIV self‐testing in sub‐Saharan Africa: a health economic and modelling analysis

  2019cited by this paper
• Economic cost analysis of door‐to‐door community‐based distribution of HIV self‐test kits in Malawi, Zambia and Zimbabwe

  2019influential reference
• Cost‐per‐diagnosis as a metric for monitoring cost‐effectiveness of HIV testing programmes in low‐income settings in southern Africa: health economic and modelling analysis

  2019cited by this paper
• Reliability of HIV rapid diagnostic tests for self-testing compared with testing by health-care workers: a systematic review and meta-analysis

  2018cited by this paper
• Effect of HIV self-testing on the number of sexual partners among female sex workers in Zambia

  2018cited by this paper
• Feasibility of HIV self-test programming among female sex workers in Zimbabwe

  2017cited by this paper
• Swaziland HIV Incidence Measurement Survey (SHIMS): a prospective national cohort study.

  2017cited by this paper
• Cost-Effectiveness of Community-based Human Immunodeficiency Virus Self-Testing in Blantyre, Malawi

  2017cited by this paper
• Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe

  2017cited by this paper
• To err is human, to correct is public health: a systematic review examining poor quality testing and misdiagnosis of HIV status

  2017influential reference
• HIV self-testing among female sex workers in Zambia: A cluster randomized controlled trial

  2017cited by this paper
• Direct provision versus facility collection of HIV self-tests among female sex workers in Uganda: A cluster-randomized controlled health systems trial

  2017cited by this paper
• Household survey of HIV incidence in Rwanda: a national observational cohort study.

  2017influential reference
• Cost-effectiveness of public-health policy options in the presence of pretreatment NNRTI drug resistance in sub-Saharan Africa: a modelling study

  2017cited by this paper
• Supporting the development of an essential health package: principles and initial assessment for Malawi

  2016cited by this paper
• Country-Level Cost-Effectiveness Thresholds: Initial Estimates and the Need for Further Research

  2016cited by this paper
• Promoting male partner HIV testing and safer sexual decision making through secondary distribution of self-tests by HIV-negative female sex workers and women receiving antenatal and post-partum care in Kenya: a cohort study.

  2016cited by this paper
• Optimum resource allocation to reduce HIV incidence across sub-Saharan Africa: a mathematical modelling study.

  2016cited by this paper
• Botswana's progress toward achieving the 2020 UNAIDS 90-90-90 antiretroviral therapy and virological suppression goals: a population-based survey.

  2016cited by this paper
• Closer to 90–90–90. The cascade of care after 10 years of ART scale-up in rural Malawi: a population study

  2016cited by this paper
• Promoting Partner Testing and Couples Testing through Secondary Distribution of HIV Self-Tests: A Randomized Clinical Trial

  2016cited by this paper
• The International Decision Support Initiative Reference Case for Economic Evaluation: An Aid to Thought.

  2016cited by this paper
• High levels of retention in care with streamlined care and universal test and treat in East Africa

  2016cited by this paper
• Undisclosed HIV infection and antiretroviral therapy use in the Kenya AIDS indicator survey 2012: relevance to national targets for HIV diagnosis and treatment

  2016cited by this paper
• Sustainable HIV treatment in Africa through viral-load-informed differentiated care

  2015cited by this paper
• Uptake, Accuracy, Safety, and Linkage into Care over Two Years of Promoting Annual Self-Testing for HIV in Blantyre, Malawi: A Community-Based Prospective Study

  2015cited by this paper
• Attitudes and Acceptability on HIV Self-testing Among Key Populations: A Literature Review

  2015cited by this paper
• Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa

  2015cited by this paper
• Assessment of the Potential Impact and Cost-effectiveness of Self-Testing for HIV in Low-Income Countries

  2015cited by this paper
• Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

  2014cited by this paper
• Is there scope for cost savings and efficiency gains in HIV services? A systematic review of the evidence from low- and middle-income countries.

  2014cited by this paper
• Maximising the effect of combination HIV prevention through prioritisation of the people and places in greatest need: a modelling study.

  2014cited by this paper
• Provider-Initiated HIV Testing and Counseling in Low- and Middle-Income Countries: A Systematic Review

  2013cited by this paper
• Voluntary counseling and testing (VCT) for changing HIV-related risk behavior in developing countries.

  2012cited by this paper
• Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010.

  2012cited by this paper
• Head-to-head comparison of accuracy of a rapid point-of-care HIV test with oral versus whole-blood specimens: a systematic review and meta-analysis.

  2012cited by this paper
• Appropriate perspectives for health care decisions.

  2010cited by this paper
• Patterns of Self-reported Behaviour Change Associated with Receiving Voluntary Counselling and Testing in a Longitudinal Study from Manicaland, Zimbabwe

  2009cited by this paper
• Estimates of the number of female sex workers in different regions of the world

  2006influential reference

• Developing and Validating an Inclusive and Cost-Effective Prediction Algorithm for Survival and Death Among People Living With HIV in Sub-Saharan Africa: Protocol for a Meta-Analysis and Case-Control and Cost-Effectiveness Study

  2025cites this paper
• Cost-effectiveness analysis in primary care research: A practical guide for early-career researchers

  2025cites this paper
• Who pays and what pays off in sexual and reproductive health? A review of the cost and cost-effectiveness of interventions and implications for future funding and markets.

  2025cites this paper
• HIV self-testing uptake and associated factors among adolescent girls and young women in certificate and diploma colleges, Dodoma, Tanzania: a cross-sectional study

  2025cites this paper
• AEGIDA: Results of a Pilot Randomized Trial of an HIV Self-Testing Intervention for Women Who Exchange Sex and Use Substances in Kazakhstan.

  2025cites this paper
• HIV self-testing lived experiences of female sex workers in the Garden City, Eastern Nigeria

  2025cites this paper
• Understanding the cost-utility of implementing HIV self-testing with digital-based supports

  2025cites this paper
• Preventing Unintended Pregnancies and HIV Through Self-Care Interventions in East and Southern Africa: Findings From a Structured Review

  2025cites this paper
• The future of HIV diagnostics: an exemplar in infectious diseases.

  2025cites this paper
• Strategies and challenges for maintaining the continuity of essential health services during a pandemic: a scoping review

  2025cites this paper
• Cost-Effectiveness Analyses of Adolescent- and Young-Adult-Focused HIV Interventions Incorporating HIV Transmission: a Scoping Review of Modeling Methods and Proposed Guidance

  2025cites this paper
• Temporal Trends and Characteristics of Community-Based HIV Testing: First Community-Based Testing Program Results of Men Who Had Sex with Men and Female Sex Workers in Haiti, 2015–2018

  2025cites this paper
• Cost‐effectiveness analysis of community‐led HIV self‐testing among key populations in Côte d'Ivoire, Mali, and Senegal

  2024cites this paper
• Policies and Practices Facilitating Access to and Uptake of HIV Testing Services among Adolescents in Sub-Sahara Africa: A Narrative Review

  2024cites this paper
• The economic costs and cost-effectiveness of HIV self-testing among truck drivers in Kenya

  2024cites this paper
• Factors Associated with the First-time HIV Testing Among Chinese men who have sex with men Who Received HIV Self-tests from Partners or Friends

  2024cites this paper
• Potential population-level effects of HIV self-test distribution among key populations in Côte d'Ivoire, Mali, and Senegal: a mathematical modelling analysis.

  2024cites this paper
• Effects of self-testing on HIV outcomes in west Africa.

  2024cites this paper
• Scaling Up HIV Self-Testing and Linkage to Care Among Women Who Exchange Sex and/or Use Drugs in Kazakhstan.

  2024cites this paper
• Evaluating the effectiveness of oral HIV self testing according to distribution models in Cameroon

  2024cites this paper
• Protocol for the economic evaluation of integrated community-based care compared with integrated facility-based care for HIV, hypertension and diabetes in Tanzania and Uganda (INTE-COMM trial)

  2024cites this paper
• Expanding HIV Self-Test Kits via Community Pharmacies in Rwanda Has Improved Availability, but Affordability Remains an Issue

  2024cites this paper
• Evidence Gaps in Economic Evaluations of HIV Interventions Targeting Young People: A Systematic Review.

  2024cites this paper
• Rethinking Tuberculosis Morbidity Quantification: A Systematic Review and Critical Appraisal of TB Disability Weights in Cost-Effectiveness Analyses

  2024cites this paper
• Modelling Methods of Economic Evaluations of HIV Testing Strategies in Sub-Saharan Africa: A Systematic Review

  2023cites this paper
• Cost of improved test and treat strategies in Indonesia

  2023cites this paper
• Strengthening diagnostic capacity in Africa as a key pillar of public health and pandemic preparedness

  2023cites this paper
• Assessing the potential population-level impacts of HIV self-testing distribution among key populations in Côte d’Ivoire, Mali, and Senegal: a mathematical modelling analysis

  2023cites this paper
• How much does HIV self-testing cost in low and middle income countries? A systematic review of evidence from economic studies

  2023cites this paper
• Estimated cost-effectiveness of point-of-care testing in community pharmacies vs. self-testing and standard laboratory testing for HIV

  2023cites this paper
• Willingness of health care providers to offer HIV self-testing from specialized HIV care services in the northeast of Brazil

  2022cites this paper
• Costs of distributing HIV self-testing kits in Eswatini through community and workplace models

  2022cites this paper
• Assessing the potential of HTA to inform resource allocation decisions in low-income settings: The case of Malawi

  2022cites this paper
• Interventions to Increase HIV Testing Uptake in Global Settings

  2022cites this paper
• Preferences for oral-fluid-based or blood-based HIV self-testing and provider-delivered testing: an observational study among different populations in Zimbabwe

  2022cites this paper
• Interventions for Maintenance of Essential Health Service Delivery during the COVID-19 Response in Uganda, between March 2020 and April 2021

  2022cites this paper
• Economic Analysis of Low Volume Interventions Using Real-World Data: Costs of HIV Self-Testing Distribution and HIV Testing Services in West Africa From the ATLAS Project

  2022cites this paper
• A community-based organisation-led HIV self-testing program among men who have sex with men in China is cheaper and more effective than facility-based HIV testing: an economic evaluation†.

  2022cites this paper
• Health impact and cost-effectiveness of HIV testing, linkage, and early antiretroviral treatment in the Botswana Combination Prevention Project

  2022cites this paper
• Expanding syphilis test uptake using rapid dual self-testing for syphilis and HIV among men who have sex with men in China: A multiarm randomized controlled trial

  2022cites this paper
• The cost effectiveness and optimal configuration of HIV self-test distribution in South Africa: a model analysis

  2021cites this paper
• Autodépistage du VIH au Canada : vision et plan d’action

  2021cites this paper
• Shortening “the Road” to Improve Engagement with HIV Testing Resources: A Qualitative Study Among Stakeholders in Rural Uganda

  2021cites this paper
• Optimizing infant HIV diagnosis with additional screening at immunization clinics in three sub‐Saharan African settings: a cost‐effectiveness analysis

  2021cites this paper
• Modelling the impact of an HIV testing intervention on HIV transmission among men who have sex with men in China

  2021cites this paper
• HIV Self-Testing Uptake and Intervention Strategies Among Men in Sub-Saharan Africa: A Systematic Review

  2021cites this paper
• Antiretroviral therapy based HIV prevention targeting young women who sell sex: a mixed method approach to understand the implementation of PrEP in a rural area of KwaZulu-Natal, South Africa

  2021cites this paper
• HIV testing approaches to reach the first UNAIDS 95% target in sub-Saharan Africa.

  2021cites this paper
• Implementation outcomes of HIV self-testing in low- and middle- income countries: A scoping review

  2021cites this paper
• Effect of community-led delivery of HIV self-testing on HIV testing and antiretroviral therapy initiation in Malawi: A cluster-randomised trial

  2021cites this paper
• Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali

  2021cites this paper
• Jointly Modelling Economics and Epidemiology to Support Public Policy Decisions for the COVID-19 Response: A Review of UK Studies

  2021cites this paper
• Effect of door-to-door distribution of HIV self-testing kits on HIV testing and antiretroviral therapy initiation: a cluster randomised trial in Malawi

  2021cites this paper
• Pragmatic economic evaluation of community-led delivery of HIV self-testing in Malawi

  2021cites this paper
• HIV self-testing: lessons learnt and priorities for adaptation in a shifting landscape

  2021cites this paper
• UNITAID STAR (SELF-TESTING AFRICA) INITIATIVE: PHASE 2 END OF PROJECT EVALUATION EVALUATION REPORT

  2021cites this paper
• Impact of a personalised, digital, HIV self-testing app-based program on linkages and new infections in the township populations of South Africa

  2021cites this paper
• Perspectives of Policymakers on the Introduction and Scale-Up of HIV Self-Testing and Implication for National HIV Programming in Ghana

  2021cites this paper
• Willingness to Offer HIV Self-testing Among Health Care Providers From Specialized HIV Care Services in the Northeast of Brazil

  2021cites this paper
• The impact and implications of COVID-19: Reflections on the Zimbabwean society

  2021cites this paper
• Usability and acceptability of oral-based HCV self-testing among key populations: a mixed-methods evaluation in Tbilisi, Georgia

  2021cites this paper
• Traditional healer-delivered point-of-care HIV testing versus referral to clinical facilities for adults of unknown serostatus in rural Uganda: a mixed-methods, cluster-randomised trial

  2021cites this paper
• Costs of Providing HIV Self-Test Kits to Pregnant Women Living with HIV for Secondary Distribution to Male Partners in Uganda

  2020cites this paper
• Implementation of community and facility‐based HIV self‐testing under routine conditions in southern Eswatini

  2020cites this paper
• Awareness, use and willingness to self-test for HIV: An analysis of cross-sectional population-based surveys in Malawi and Zimbabwe

  2020cites this paper
• Antiretroviral Therapy Based Hiv Prevention Targeting Young Female-Sex Workers: A Mixed Method Approach to Understand the Implementation of Prep in a Rural Area of Kwazulu-Natal, South Africa

  2020cites this paper
• An Economic Evaluation of a Community-Based Organization Led HIV Self-Testing Program Among Men Who Have Sex With Men in China

  2020cites this paper
• Acceptability of HIV self-testing is low among MSM who have not tested: a study with respondent-driven sampling in Brazil

  2020cites this paper
• Evidence-Based Global Health

  2020cites this paper
• Acceptability of HIV self-testing is low among men who have sex with men who have not tested for HIV: a study with respondent-driven sampling in Brazil

  2020cites this paper
• Time for HIV self-testing in Canada: a vision and an action plan

  2020cites this paper
• Using HIV self-testing to increase the affordability of community-based HIV testing services

  2020cites this paper
• Correlates of HIV self-testing among female sex workers in China: implications for expanding HIV screening

  2020cites this paper
• Practical metrics for establishing the health benefits of research to support research prioritisation

  2020cites this paper
• Male partner testing and sexual behaviour following provision of multiple HIV self‐tests to Kenyan women at higher risk of HIV infection in a cluster randomized trial

  2020cites this paper
• An implementation study of oral and blood‐based HIV self‐testing and linkage to care among men in rural and peri‐urban KwaZulu‐Natal, South Africa

  2020cites this paper
• Use and awareness of and willingness to self-test for HIV: an analysis of cross-sectional population-based surveys in Malawi and Zimbabwe

  2020cites this paper
• Economic cost analysis of door‐to‐door community‐based distribution of HIV self‐test kits in Malawi, Zambia and Zimbabwe

  2019cites this paper
• Applying user preferences to optimize the contribution of HIV self‐testing to reaching the “first 90” target of UNAIDS Fast‐track strategy: results from discrete choice experiments in Zimbabwe

  2019cites this paper
• HIV self-testing services for female sex workers, Malawi and Zimbabwe

  2019cites this paper
• Optimal HIV testing strategies for South Africa: a model-based evaluation of population-level impact and cost-effectiveness

  2019cites this paper
• Cost‐per‐diagnosis as a metric for monitoring cost‐effectiveness of HIV testing programmes in low‐income settings in southern Africa: health economic and modelling analysis

  2019cites this paper
• To thine own test be true: HIV self‐testing and the global reach for the undiagnosed

  2019cites this paper
• The Self‐Testing AfRica (STAR) Initiative: accelerating global access and scale‐up of HIV self‐testing

  2019cites this paper
• The impact and cost‐effectiveness of community‐based HIV self‐testing in sub‐Saharan Africa: a health economic and modelling analysis

  2019cites this paper
• COSTING AND FINANCING FOR SELF-CARE FOR SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS: A REVIEW OF EVIDENCE AND COUNTRY CONSULTATIONS IN LOW-AND MIDDLE-INCOME COUNTRIES IN AFRICA

  year unknowncites this paper