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Table 1 Safer conception cost analysis scenarios

From: Estimated costs for the delivery of safer conception strategies for HIV-discordant couples in Zimbabwe: a cost analysis

Scenario Description Components and context
0) SAFER Study Total cost as observed in the clinical trial, including high intensity of resource use and above-market prices. Incremental to current practice as observed in trial. • High private sector prices
• Monthly visits and monitoring until pregnancy confirmed
• Up to 12 months of conception attempts
• 100% of trial participants used MOHCC delivered ART, therefore no ART cost included in this scenario
• Full costs for delivery of VL testing, PrEP, AVI, and SW
1) High Intensity + Real-world Prices Same resource intensity as above, but using prices normally paid by the Zimbabwe MOHCC. • Public sector prices
• Monthly visits and monitoring until pregnancy confirmed
• Up to 12 months of conception attempts
• Full costs for delivery of VL testing, PrEP, AVI, and SW
2) Target Intensity, Incremental Cost Added to Current Practice Target resource intensitya, incremental to current population service coverage for HIV treatment and prevention. • Public sector prices
• After strategy initiation, visits and monitoring q3–6 months until pregnancy confirmed
• Up to 12 months of conception attempts
• With 72% ART coverage in community, includes costs to provide ART for 28% of HIV+, ART-naive individuals
• Includes costs for needed VL tests beyond those recommended in MOHCC guidelines
• Full costs for delivery of PrEP, AVI, SW, safer conception counselling
3) Target Intensity, Incremental Cost Added to Standard of Care Same as above, except incremental to current MOHCC-specified standard of care. • Public sector prices
• After strategy initiation, visits and monitoring q3–6 months until pregnancy confirmed
• Up to 12 months of conception attempts
• No costs for ART and PrEP, which are in MOHCC guidelines as standard of care
• Includes costs for needed VL tests beyond those recommended in MOHCC guidelines
• Includes full costs for delivering AVI, SW, safer conception counselling
  1. a For a summary of target resource intensity, see Fig. 1; for a full description and definition of target resource intensity, see Supplement A
  2. ART = Antiretroviral therapy. ART-VL = Antiretroviral therapy with frequent viral load testing. AVI = Artificial vaginal insemination, at home. MOHCC = Ministry of Health and Child Care. PrEP = Pre-exposure prophylaxis. SOC =Standard of Care. SW = Semen-washing