The Incremental Cost of Delivering PrEP as a Bridge to ART for HIV Serodiscordant Couples in Public HIV Care Clinics in Kenya.

摘要: Background. In 2016, the Kenyan Ministry of Health (MOH) released guidelines that recommend preexposure prophylaxis (PrEP) for persons with substantial ongoing HIV risk, including those in serodiscordant partnerships. Estimates costs delivering PrEP within public health facilities are needed planning scale up. Methods. We estimated incremental annual providing to uninfected partners as a time-limited “bridge” until infected partner is virally suppressed on ART couples part routine clinic care Thika, Kenya. Costs were collected from Partners Demonstration Project, prospective evaluation integrated delivery and antiretroviral therapy (ART) high-risk couples. conducted time motion studies distinguish between activities related research, clinical care, delivery. (2015 US dollars) MOH perspective divided into staff, transportation, equipment, supplies, buildings overhead, start-up. Results. during screening, enrollment, follow-up visits took an average 13 minutes, 51 12 respectively. Assuming staff structure 3 counselors, 1 nurse, 2 clinicians, we estimate 3,178 can be screened, 1,444 offered ART, 6,138 followed up annually clinic. Using incurred by personnel, drug, laboratory tests, cost offering existing programs $86.79 per couple year. Personnel medication made largest portion costs. total program $250.19 Conclusions. Time-limited provision affordable model implemented Kenya similar settings. These used budgetary effectiveness analyses.