Unformatted text preview: ts (costs
comparable to other published expenses related to providing testing services are comparable).22
In a setting such as Malawi, with an overall HIV prevalence rate of approximately 10 percent,
at least ten individuals would have to be tested using a door-to-door approach to inform one HIVpositive individual of her status. The cost for this could range between $80 (the lowest estimated
cost published (Forsythe et al. 2002) and $537 (the highest estimated cost (MDICP)). Further, the
results of this study indicate that this program would have no significant effect on nonsubsidized
condom purchases or on the probability of having sex, although it might have an effect in uptake 21 The HIV tests and related fees (e.g., equipment for sample collection, laboratory and processing fees) constituted
the largest proportion of costs. Labor (e.g., salary, accommodations, and benefits) accounted for the second largest
proportion of costs, followed by transportation costs that include vehicle rental and fuel to transport employees to the
rural study sites, as well as the cost of transporting HIV samples to the laboratory. Training for collecting HIV samples
lasted approximately one week and included the costs of paying salaries, instructors, and room rental fees; training for
post-test counseling was a two-day seminar. Supplies included employee uniforms, freezers and cold packs for HIV
samples, portable tents, and other necessary supplies and equipment.
One study of clients’ willingness to pay for VCT services in Kenya (Forsythe et al. 2002) estimated a total cost
of $16.03 per client for three health centers during 1999. It is worth noting that this was the calculated “incremental”
cost, which did not include donated items. The total cost was $47.34 per client before subtracting these other costs.
This paper also suggested that with certain cost-savings steps, the costs could be reduced to as little as $8.00 per client. Another study of clinics in Kenya and Tanzania reported a cost of $26.65...
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