INCREASING ACCESS TO HIV COUNSELING AND TESTING THROUGH MOBILE SERVICES IN KENYA: STRATEGIES UTILIZATION AND COST-EFFECTIVENESS

摘要

This study compares client volume, demographics, testing results and costs of three ‘mobile’ HIV counseling and testing (HCT) approaches with existing ‘stand-alone’ HCT in Kenya. A retrospective cohort of 62,173 individuals receiving HCT between May 2005 and April 2006, was analyzed. Mobile HCT approaches assessed were community-site mobile HCT, semi-mobile container HCT, and fully mobile truck HCT. Data were obtained from project monitoring data, project accounts and personnel interviews.ResultsMobile HCT reported a higher proportion of clients with no prior HIV test than stand-alone (88% vs. 58%). Stand-alone HCT reported a higher proportion of couples than mobile HCT (18% vs. 2%), and a higher proportion of discordant couples (12% vs. 4%). The incremental cost-effectiveness of adding mobile HCT to stand-alone services was $14.91 per client tested (vs. $26.75 for stand-alone HCT); $16.58 per previously untested client (vs. $43.69 for stand-alone HCT); and $157.21 per HIV-positive individual identified (vs. $189.14 for stand-alone HCT).