Cost Analysis of Short Messaging Service and Peer Navigator Interventions for Linking and Retaining Adults Recently Diagnosed With HIV in Care in South Africa.

Autor:	Shade SB; Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA.; Division of Infectious Disease and Global Epidemiology, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA., Gutin SA; Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA.; Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA., Agnew E; Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA., Grignon JS; Department of Global Health, University of Washington, Seattle; WA.; International Training and Education Center for Health-South Africa, Pretoria, Republic of South Africa ., Gilmore H; Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA., Ratlhagana MJ; International Training and Education Center for Health-South Africa, Pretoria, Republic of South Africa ., Sumitani J; International Training and Education Center for Health-South Africa, Pretoria, Republic of South Africa ., Steward WT; Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA., Lippman SA; Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2024 Apr 15; Vol. 95 (5), pp. 417-423.
DOI:	10.1097/QAI.0000000000003371
Abstrakt:	Introduction: Large proportions of people living with HIV (PLHIV) in sub-Saharan Africa are not linked to or retained in HIV care. There is a critical need for cost-effective interventions to improve engagement and retention in care and inform optimal allocation of resources. Methods: We estimated costs associated with a short message service (SMS) plus peer navigation (SMS+PN) intervention; an SMS-only intervention; and standard of care (SOC), within the I-Care cluster-randomized trial to improve HIV care engagement for recently diagnosed PLHIV. We employed a uniform cost data-collection protocol to quantify resources used and associated costs for each intervention. Results: Compared with SOC, the SMS+PN intervention cost $1284 ($828-$2859) more per additional patient linked to care within 30 days and $1904 ($1158-$5343) more per additional patient retained in care at 12 months, while improving linkage by 24% (95% CI: 11 to 36) and retention by 16% (95% CI: 6 to 26). By contrast, the SMS-only intervention cost $198 ($93-dominated) more per additional patient linked to care and $697 ($171-dominated) more per additional patient retained in care but was not significantly associated with improvements in linkage (12%; 95% CI: -1 to 25) or retention (3%; 95% CI: -7 to 14) compared with SOC. The efficiency of the SMS+PN intervention could be improved by 46%, to $690 more per additional patient linked and $1023 more per additional patient retained in care, if implemented within the Department of Health using more efficient distribution of staff resources. Discussion: Findings suggest that scale-up of the SMS+PN intervention could benefit patients, improving care and health outcomes while being cost-effective. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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