HIV testing is an entry point to effective antiretroviral treatment among persons living with HIV. There are many strategies underway to shorten the time from infection to diagnosis in an effort to link to early antiretroviral treatment and care. Strategies include innovative, community-led programs tailored to reach communities most affected by HIV.
The goal of this body of work is to rigorously evaluate the potential health and economic impact of different and new ways of implementing HIV self-testing across communities and health-system contexts within Canada. We aim to answer: what is the best implementation strategy to improve health and represent good value for money, and in which contexts?
With this study, the researchers aim to develop a mathematical model designed to evaluate implementation strategies for HIV self-testing across Canada.
Initiative objectives and goals
This study aims to estimate the cost of developing and implementing self-testing strategies including:
- REACH Nexus’s I’m Ready research program;
- CBRC’s – Sex Now Test@Home Edition;
- McGill’s - App-based intervention with HIVSmart;
- Approach 2.0’s - Pharmacy-based testing;
- PHAC’s – Dried blood spot testing
The study will also estimate the cost-effectiveness of these strategies compared with usual care from the publicly funded health care system’s perspective, and the budgetary impact of implementing and scaling up these innovative HIV self-testing strategies in Canada. The study will involve micro-costing of each implementation strategy and estimating the attributable cost of HIV care in Ontario.
The role of this initiative to end the HIV epidemic
By comparing the economic impact of implementation strategies and the budgetary impact of scaling them up with current testing options available through the public healthcare system, this study will help policymakers and service providers select and implement the most efficient strategy for their local epidemiologic context. In doing so, findings have the potential to support a sustainable effort for more effective and efficient access and uptake of HIV testing with the highest chance of improving health at the individual and population-level.
Meaningful engagement with people with lived experience
Each of the innovative HIV self-testing implementation strategies covered in the scope of this study are meaningfully engaging with people with lived experience.
A REACH-funded initiative
Kednapa Thavorn, Ottawa Health Research Institute and University of Ottawa
Alice Zwerling, University of Ottawa
Sharmistha Mishra, Department of Medicine, University of Toronto and St Michael’s Hospital, Unity Health Toronto
Key performance indicators
Results will be shared at a later date with preliminary findings and upon study completion.