1. Katharina Hauck On behalf of the HPTN 071 Study Team
COSTS OF HOME-BASED HIV TESTING IN ZAMBIA: EVIDENCE FROM THE HPTN 071 (PopART) STUDY
Katharina Hauck On behalf of the HPTN 071 Study Team

2. Background
14.5 of the 36.7 million people living with HIV globally do not know their HIV status
Testing critical first step in ending the epidemic
Home-based testing and counselling (HBTC)
Limited evidence on the costs of HBTC
Cost per person tested: $5.80 to $38.80
Cost per person tested positive: $42.40 to $454.40
The HPTN 071 (PopART) trial

3. HPTN 071 (PopART)
Trial in 12 communities in Zambia (and 9 in South Africa)
Cluster randomized trial
Combination prevention package
Impact on HIV incidence
HBTC delivered by 412 community HIV-care providers (CHiPs)
CHIPs work in pairs

4. Research question Costs of HBTC under HPTN071 (PopART) Estimates of
total costs per year
cost per person tested
cost per person testing positive
Data from 8 communities in Zambia
HBTC delivered to over 250,000 individuals
Between December 2013 and December 2016

5. Methodology Micro-costing methods
Data on salaries, equipment, supplies, transport, and general administration from program records
Merged with outcome indicators from program data
Allocation rules to communities
Personnel costs by number of CHiPs teams
HIV testing costs by number of tests
other costs by population covered

6. Methodology
Equivalent annual costs for equipment and training over the lifetime of the study
Inflation-adjusted in 2016 US$
Probabilistic sensitivity analysis by random sampling from specified distributions
Costs are presented as means from the simulations

7. Findings 1st round 2nd round 126,208 individuals tested
9,196 (7%) tested HIV-positive (of those tested)
2nd round
136,966 individuals tested
4,921 (3.6%) tested HIV-positive (of those tested)

8. Findings

9. Findings

10. Interpretation
Costs are sensitive to community-specific factors related to
service delivery
population characteristics
Cost per person tested HIV-positive nearly doubled between rounds
Partly explained by a reduction in positivity rate
Further analysis required to evaluate the cost-effectiveness of HBTC

11. acknowledgements
Sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) under Cooperative Agreements # UM1 AI068619, UM1-AI068617, and UM1-AI068613
Funded by:
The U.S. President's Emergency Plan for AIDS Relief (PEPFAR)
The International Initiative for Impact Evaluation (3ie) with support from the Bill & Melinda Gates Foundation
NIAID, the National Institute of Mental Health (NIMH), and the National Institute on Drug Abuse (NIDA) all part of the U.S. National Institutes of Health (NIH)

12. The HPTN 071 Study Team, led by: PEPFAR Implementing Partners:
Dr. Richard Hayes
Dr. Sarah Fidler
Dr. Helen Ayles
Dr. Nulda Beyers
Dr. Peter Bock
Government Agencies:
PEPFAR Implementing Partners:

13. With thanks to: All research participants and their families
The 21 research communities and their religious, traditional, secular and civil leadership structures
Volunteers in the community advisory board structures