{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T21:27:49Z","timestamp":1770326869871,"version":"3.49.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0212972","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T14:01:41Z","timestamp":1551276101000},"page":"e0212972","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Economic and public health impact of decentralized HIV viral load testing: A modelling study in Kenya"],"prefix":"10.1371","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9927-122X","authenticated-orcid":true,"given":"M.","family":"de Necker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. C.","family":"de Beer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. P.","family":"Stander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. D.","family":"Connell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Mwai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2019,2,27]]},"reference":[{"key":"ref1","unstructured":"AVERT. HIV and AIDS in Kenya. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.avert.org\/professionals\/hiv-around-world\/sub-saharan-africa\/kenya#footnote1_647p0kq\" xlink:type=\"simple\">https:\/\/www.avert.org\/professionals\/hiv-around-world\/sub-saharan-africa\/kenya#footnote1_647p0kq<\/ext-link> Cited 6 February 2018."},{"key":"ref2","unstructured":"UNAIDS. Kenya Country Factsheets (2016). <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.unaids.org\/en\/regionscountries\/countries\/kenya\" xlink:type=\"simple\">http:\/\/www.unaids.org\/en\/regionscountries\/countries\/kenya<\/ext-link>."},{"issue":"4","key":"ref3","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.jecm.2012.06.007","article-title":"HIV and AIDS Epidemic in Kenya: An Overview","volume":"4","author":"R Lupia","year":"2012","journal-title":"J Exp Clin Med"},{"key":"ref4","unstructured":"Kenya Ministry of Health. Kenya AIDS Response Progress Report 2016. 2016. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/nacc.or.ke\/wp-content\/uploads\/2016\/11\/Kenya-AIDS-Progress-Report_web.pdf\" xlink:type=\"simple\">http:\/\/nacc.or.ke\/wp-content\/uploads\/2016\/11\/Kenya-AIDS-Progress-Report_web.pdf<\/ext-link>."},{"issue":"12","key":"ref5","doi-asserted-by":"crossref","first-page":"e592","DOI":"10.1016\/S2352-3018(16)30120-5","article-title":"Evaluating strategies to improve HIV care outcomes in Kenya: a modelling study","volume":"3","author":"J Olney","year":"2016","journal-title":"Lancet HIV"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1097\/QAD.0000000000000741","article-title":"Cascade of HIV care and population viral suppression in a high-burden region of Kenya","volume":"29","author":"D Maman","year":"2015","journal-title":"AIDS"},{"issue":"1","key":"ref7","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1086\/510073","article-title":"HIV Viral Load Monitoring in Resource\u2010Limited Regions: Optional or Necessary?","volume":"44","author":"A Calmy","year":"2007","journal-title":"Clin Infect Dis"},{"key":"ref8","unstructured":"World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Recommendations for a public health approach. 2016. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/apps.who.int\/iris\/bitstream\/10665\/208825\/1\/9789241549684_eng.pdf?ua=1\" xlink:type=\"simple\">http:\/\/apps.who.int\/iris\/bitstream\/10665\/208825\/1\/9789241549684_eng.pdf?ua=1<\/ext-link>."},{"issue":"7","key":"ref9","doi-asserted-by":"crossref","first-page":"e0158881","DOI":"10.1371\/journal.pone.0158881","article-title":"Positive Predictive Value of the WHO Clinical and Immunologic Criteria to Predict Viral Load Failure among Adults on First, or Second-Line Antiretroviral Therapy in Kenya","volume":"11","author":"A Waruru","year":"2016","journal-title":"PLOS ONE"},{"issue":"1","key":"ref10","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/QAI.0b013e318227fc34","article-title":"Unnecessary Antiretroviral Treatment Switches and Accumulation of HIV Resistance Mutations; Two Arguments for Viral Load Monitoring in Africa","volume":"58","author":"K Sigaloff","year":"2011","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"8","key":"ref11","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1093\/cid\/ciw001","article-title":"Scale-up of Routine Viral Load Testing in Resource-Poor Settings: Current and Future Implementation Challenges: Table 1","volume":"62","author":"T Roberts","year":"2016","journal-title":"Clin Infect Dis"},{"key":"ref12","unstructured":"Medecins Sans Frontieres Access Campaign. How low can we go? Pricing for HIV viral load testing in low- and middle-income countries. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.msf.org\/sites\/msf.org\/files\/how_low_can_we_go_vl_pricing_brief.pdf\" xlink:type=\"simple\">http:\/\/www.msf.org\/sites\/msf.org\/files\/how_low_can_we_go_vl_pricing_brief.pdf<\/ext-link>."},{"key":"ref13","unstructured":"Cepheid GeneXpert IV. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.cepheid.com\/us\/cepheid-solutions\/systems\/genexpert-systems\/genexpert-iv\" xlink:type=\"simple\">http:\/\/www.cepheid.com\/us\/cepheid-solutions\/systems\/genexpert-systems\/genexpert-iv<\/ext-link> Cited 12 March 2018."},{"issue":"2","key":"ref14","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1183\/13993003.00543-2016","article-title":"Development, roll-out and impact of Xpert MTB\/RIF for tuberculosis: what lessons have we learnt and how can we do better?","volume":"48","author":"H Albert","year":"2016","journal-title":"Eur Respir J"},{"key":"ref15","unstructured":"ZE Currency Converter: KES to USD. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.xe.com\/currencyconverter\/convert\/?Amount=1&From=KES&To=USD\" xlink:type=\"simple\">http:\/\/www.xe.com\/currencyconverter\/convert\/?Amount=1&amp;From=KES&amp;To=USD<\/ext-link>."},{"key":"ref16","unstructured":"KNBS\u2013Kenyan National Bureau of Statistics. Economic survey 2017. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.devolutionplanning.go.ke\/images\/hb\/Economic%20Survey%202017.pdf\" xlink:type=\"simple\">http:\/\/www.devolutionplanning.go.ke\/images\/hb\/Economic%20Survey%202017.pdf<\/ext-link> Cited 29 June 2017."},{"issue":"9","key":"ref17","doi-asserted-by":"crossref","first-page":"453","DOI":"10.4103\/1947-2714.141636","article-title":"Predictors of Loss to follow-up in Patients Living with HIV\/AIDS after Initiation of Antiretroviral Therapy","volume":"6","author":"TM Berheto","year":"2014","journal-title":"N Am J Med Sci"},{"key":"ref18","unstructured":"Rachlis B, Genberg B, Musick B, Simiyu G, Hogan J, Braitstein P. Gaps in care among adults receiving HIV care in western Kenya. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.iapac.org\/tasp_prep\/presentations\/TPSlon14_OA0088.pdf\" xlink:type=\"simple\">www.iapac.org\/tasp_prep\/presentations\/TPSlon14_OA0088.pdf<\/ext-link>."},{"key":"ref19","unstructured":"Roberts T. Medecins Sans Frontieres Access Campaign. Will POC make any difference? A perspective on EID, CD4 and viral load. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/sahivsoc2014.co.za\/wp-content\/uploads\/2014\/10\/Thurs_Teri_Roberts%20Pointless%20Point%20of%20view%20Will%20POC%20make%20any%20difference.pdf\" xlink:type=\"simple\">http:\/\/sahivsoc2014.co.za\/wp-content\/uploads\/2014\/10\/Thurs_Teri_Roberts%20Pointless%20Point%20of%20view%20Will%20POC%20make%20any%20difference.pdf<\/ext-link>."},{"issue":"12","key":"ref20","doi-asserted-by":"crossref","first-page":"e0168244","DOI":"10.1371\/journal.pone.0168244","article-title":"Options to Expand HIV Viral Load Testing in South Africa: Evaluation of the GeneXpert<sup>\u00ae<\/sup> HIV-1 Viral Load Assay","volume":"11","author":"N Gous","year":"2016","journal-title":"PLoS One"},{"issue":"9635","key":"ref21","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/S0140-6736(08)61115-0","article-title":"Relation between HIV viral load and infectiousness: a model-based analysis","volume":"372","author":"DP Wilson","year":"2008","journal-title":"Lancet"},{"issue":"5","key":"ref22","doi-asserted-by":"crossref","first-page":"e179","DOI":"10.1097\/QAI.0000000000000075","article-title":"Tracing of Patients Lost to Follow-up and HIV Transmission: Mathematical Modeling Study Based on 2 Large ART Programs in Malawi","volume":"65","author":"J Estill","year":"2014","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"12","key":"ref23","doi-asserted-by":"crossref","first-page":"e47391","DOI":"10.1371\/journal.pone.0047391","article-title":"Monitoring HIV Viral Load in Resource Limited Settings: Still a Matter of Debate?","volume":"7","author":"M Arnedo","year":"2012","journal-title":"PLoS One"},{"key":"ref24","unstructured":"National AIDS &amp; STI Control Program (NASCOP), Ministry of Health Kenya. Guidelines on Use of Antiretroviral Drugs for Treating and Preventing HIV Infection in Kenya. 2016."},{"key":"ref25","unstructured":"National Average Turnaround Time. National AIDS\/STD Control Programme (NASCOP). <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/viralload.nascop.org\/\" xlink:type=\"simple\">http:\/\/viralload.nascop.org\/<\/ext-link> Cited 16 November 2017."},{"key":"ref26","unstructured":"National ACT Dashboard. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.nascop.or.ke\/wp-content\/uploads\/2016\/07\/National-ACT-Dashboard-1.xlsx\" xlink:type=\"simple\">www.nascop.or.ke\/wp-content\/uploads\/2016\/07\/National-ACT-Dashboard-1.xlsx<\/ext-link> Cited 1 December 2016."},{"key":"ref27","unstructured":"Kenya AIDS Indicator Survey 2012. Final Report June 2014. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/nacc.or.ke\/wp-content\/uploads\/2015\/10\/KAIS-2012.pdf\" xlink:type=\"simple\">http:\/\/nacc.or.ke\/wp-content\/uploads\/2015\/10\/KAIS-2012.pdf<\/ext-link> Cited 13 March 2018."},{"issue":"14","key":"ref28","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1097\/00002030-200109280-00012","article-title":"Viral load as an independent risk factor for opportunistic infections in HIV-infected adults and adolescents","volume":"15","author":"JE Kaplan","year":"2001","journal-title":"AIDS"},{"issue":"3","key":"ref29","doi-asserted-by":"crossref","first-page":"e1001015","DOI":"10.1371\/journal.pmed.1001015","article-title":"Triple-antiretroviral prophylaxis to prevent mother-to-child HIV transmission through breastfeeding\u2014the Kisumu Breastfeeding Study, Kenya: a clinical trial","volume":"8","author":"TK Thomas","year":"2011","journal-title":"PLoS Med"},{"key":"ref30","unstructured":"Cintron, C. Costs of HIV viral load testing using POC and central laboratories: assessing an efficient viral load testing network in Kenya. IAS2017. TULBPED44\u2014Poster Exhibition. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/programme.ias2017.org\/Abstract\/Print\/?abstractid=5765\" xlink:type=\"simple\">http:\/\/programme.ias2017.org\/Abstract\/Print\/?abstractid=5765<\/ext-link> Cited 14 November 2017."},{"key":"ref31","unstructured":"Kenya Subsidiary Legislation, 2016. Legal Notice No. 131. The Medical Practitioners and Dentists Board Act. Fees Guidelines for Medical &amp; Dental Practitioners."},{"issue":"3","key":"ref32","first-page":"28","article-title":"Costing of Antiretroviral Treatment in Mbagathi District Hospital, Kenya","volume":"4","author":"EA Owiti","year":"2015","journal-title":"International Journal of Innovative Research and Development"},{"key":"ref33","unstructured":"CDC and Kenya Ministry of Health. The Cost of Comprehensive HIV Treatment in Kenya. August 2013. nacc.or.ke\/wp-content\/uploads\/2016\/03\/Report-ART-Costing-Project-Kenya1.pdf."},{"issue":"3","key":"ref34","doi-asserted-by":"crossref","first-page":"ofw16","DOI":"10.1093\/ofid\/ofw161","article-title":"Point-of-Care Viral Load Testing for Sub-Saharan Africa: Informing a Target Product Profile","volume":"3","author":"AN Phillips","year":"2016","journal-title":"Open Forum Infect Dis"},{"key":"ref35","unstructured":"Jouquet G. Economic evaluation of viral load testing and early infant diagnosis in rural Zimbabwe. MSF-OCB December 2016. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/aidsfree.usaid.gov\/sites\/default\/files\/economic_vleid_zim_2016.pdf\" xlink:type=\"simple\">https:\/\/aidsfree.usaid.gov\/sites\/default\/files\/economic_vleid_zim_2016.pdf<\/ext-link> Cited 25 October 2018."},{"issue":"3","key":"ref36","doi-asserted-by":"crossref","first-page":"e0193577","DOI":"10.1371\/journal.pone.0193577","article-title":"Multidisease testing for HIV and TB using the GeneXpert platform: A feasibility study in rural Zimbabwe","volume":"13","author":"Z Ndlovu","year":"2018","journal-title":"PLoS One"},{"key":"ref37","article-title":"9th International AIDS Society on HIV Science (IAS 2017)","author":"C Cintron","year":"2017"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/dx.plos.org\/10.1371\/journal.pone.0212972","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,5,8]],"date-time":"2020-05-08T18:22:53Z","timestamp":1588962173000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0212972"}},"subtitle":[],"editor":[{"given":"David P","family":"Wilson","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2019,2,27]]},"references-count":37,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0212972","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,27]]}}}