Optimising the cost and delivery of HIV counselling and testing services in Kenya and Swaziland.

Background: Approaches to HIV counselling and testing (HCT) within low-resource high HIV prevalence settings have shifted over the years from primarily client-initiated approaches to provider initiated. As part of an ongoing programme science research agenda, we examine the relative costs of provider-initiated testing and counselling (PITC) services compared with voluntary counselling and testing (VCT) services in the same health facilities in two low-resource settings: Kenya and Swaziland.

Methods: Annual financial and economic costs and output measures were collected retrospectively from 28 health facilities.