How much would you say an HIV test costs? The price of a couple of coffees maybe, a tenner, or perhaps the cost of a round of drinks for you and your mates in the pub? Well, the actual cost is estimated to be £160 for a rapid HIV test and once that’s combined with a test for other STIs there’s not much change from £300 (see here ). What about ongoing treatment and testing for those who are already HIV positive? Well, the cost over a year varies depending on treatment combination, diagnosis stage, whether wider costs e.g. housing is included, but estimates vary from about £2,000 to about £18,000 and this might be rising as new, more effective treatment becomes available and those that are HIV positive are becoming resistant to the treatment they are on. So, testing for HIV and other STIs, as well as ongoing HIV treatment, is expensive and there are attempts to reduce the cost of both testing and treatment. Sometimes the high costs might even result in a patient receiving different treatment based on where they are living in a city and which hospital they attend. For example, according to Avert 13% of HIV clinicians decided not to offer a certain type of HIV medication because of budget constraints and 1 in 5 have restricted the prescribing of certain drugs due to the cost involved.
So, what attempts are being made to reduce the cost of testing and treatment and how effective are they? This week a report was published based on a study by researchers in Cape Town showing that they had developed a low cost computer based tool to test for HIV resistance for those that are HIV positive. Costs are reduced to about a fifth of their current level as testing up to 50 patients’ testing samples together, rather than separately as is normally done. There is also research which attempts to reduce the cost of HIV testing (see here, for example ). Again this might include pooling of serum samples before testing and ensuring the best possible purchase prices of testing materials. This is especially important in developing countries where the cost of testing can often represent a significant barrier to testing availability. In another interesting study, which was based on South Africa, a mathematical model was taken and applied to determine the hypothetical effect of enforcing universal voluntary HIV testing and immediate treatment with anti-retroviral therapy (where appropriate). Although there are many that would say this would be a controversial approach to take, the study showed that it would result in a significant and sharp reduction in HIV incidence and HIV mortality within 5 years. Not only that, but costs of this HIV strategy would also fall over time to an estimated $1.7bn by 2032 (if it had been implemented in 2032), whereas the current South African approach is likely to see consistently higher costs between now and then.
Whether the approaches above are viable and whether they will be adopted outside of the research setting remain to be seen. One thing seems to be certain, prevention is cheaper than treatment, certainly at the moment at least. Putting money into effective HIV prevention can save a huge amount of money, especially when compared with the cost of HIV treatment. That’s why programmes such as those that are part of the GMI Partnership’s HIV prevention work are so important and why they can provide a cost effective approach to HIV health work. The GMI Partnership offer counselling, mentoring and one-on-one sexual health sessions that can help HIV negative men play safe sexually and reduce their chance of becoming HIV positive. For more information on the programmes we offer please see our website or contact firstname.lastname@example.org or call us on 020 71600941.
The article reflects the views of the author and does not necessarily reflect those of the GMI Partnership.