Background. In 2016, the Kenyan Ministry of Health (MOH) released guidelines that recommend preexposure prophylaxis (PrEP)\nfor persons with substantial ongoing HIV risk, including those in HIV serodiscordant partnerships. Estimates of the costs of\ndelivering PrEP within Kenyan public health facilities are needed for planning for PrEP scale up. Methods. We estimated the\nincremental annual costs of providing PrEP to HIV uninfected partners as a time-limited â??bridgeâ? until the infected partner is\nvirally suppressed on ART within HIV serodiscordant couples as part of routine clinic care inThika, Kenya. Costs were collected\nfrom the Partners Demonstration Project, a prospective evaluation of integrated delivery of preexposure prophylaxis (PrEP) and\nantiretroviral therapy (ART) to high-risk HIV serodiscordant couples. We conducted time and motion studies to distinguish\nbetween activities related to research, routine clinical care, and PrEP delivery. Costs (2015 US dollars) were collected from the\nMOH perspective and divided into staff, transportation, equipment, supplies, buildings and overhead, and start-up. Results. PrEP\nrelated activities conducted during the screening, enrollment, and follow-up visits took an average of 13 minutes, 51 minutes, and\n12 minutes, respectively. Assuming a staff structure of 3 counselors, 1 nurse, and 2 clinicians, we estimate that 3,178 couples can\nbe screened, 1,444 couples offered PrEP and ART, and 6,138 couples followed up annually in an average HIV care clinic. Using\ncosts incurred by the MOH for personnel, drug, and laboratory tests, we estimate that the incremental cost of offering PrEP to\nHIV uninfected partners within existing ART programs is $86.79 per couple per year. Personnel and PrEP medication made up the\nlargest portion of the costs.We estimate that the total cost toMinistry of Health of delivering integrated PrEP and ART program in\npublic health facilities is $250.19 per HIV serodiscordant couple per year. Conclusions. Time-limited provision of PrEP to the HIV\nuninfected partner within HIV serodiscordant couples can be an affordable delivery model implemented in HIV care programs in\nKenya and similar settings. These costs can be used for budgetary planning and cost effectiveness analyses.
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