Resum
The non-decreasing incidence of HIV among men who have sex with men (MSM) has motivated the
emergence of Community Based Voluntary Counselling and Testing (CBVCT) services specifically
addressed to MSM. The CBVCT services are characterized by facilitated access and linkage to
care, a staff largely constituted by voluntary peers, and private not-for-profit structures outside
the formal health system institutions. Encouraging results have been measured about their
effectiveness, but these favourable results may have been obtained at high costs, questioning
the opportunity to expand the experience. We performed an economic evaluation of HIV testing
for MSM at CBVCT services, and compared them across six European cities. We collected
retrospective data for six CBVCT services from six cities (Copenhagen, Paris, Lyon, Athens, Lisbon,
and Ljubljana), for the year 2014, on the number of HIV tests and HIV reactive tests, and on all
expenditures to perform the testing activities. The total costs of CBVCTs varied from 54,390€ per
year (Ljubljana) to 245,803€ per year (Athens). The cost per HIV test varied from to 41€ (Athens)
to 113€ (Ljubljana). The cost per HIV reactive test varied from 1966€ (Athens) to 9065€
(Ljubljana). Our results show that the benefits of CBVCT services are obtained at an acceptable
cost, in comparison with the literature (values, mostly from the USA, range from 1600$ to 16,985
$ per HIV reactive test in clinical and non-clinical settings). This result was transversal to several
European cities, highlighting that there is a common CBVCT model, the cost of which is
comparable regardless of the epidemiological context and prices. The CBVCT services represent
an effective and “worth it” experience, to be continued and expanded in future public health.
Autoria:
PERELMAN, Julián;
ROSADO, Ricardo;
AMRI, Omar;
MOREL, Stéphane;
ROJAS CASTRO, Daniela;
CHANOS, Sophocles;
CIGAN, Bojan;
LOBNIK, Miha;
FUERTES, Ricardo;
PICHON, François;
SLAAEN KAYE, Peer;
AGUSTÍ BENITO, Cristina;
FERNÁNDEZ LÓPEZ, Laura;
LORENTE, Nicolas;
CASABONA BARBARÀ, Jordi