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Patient costs incurred by people living with HIV/AIDS prior to ART initiation in primary healthcare facilities in Gauteng, South Africa
- Source :
- PLoS ONE, Vol 14, Iss 2, p e0210622 (2019), PLoS ONE
- Publication Year :
- 2019
- Publisher :
- Public Library of Science (PLoS), 2019.
-
Abstract
- PurposeTo quantify costs to patients of accessing HIV care prior to ART initiation.Materials and methodsUsing a cross-sectional study design, costs incurred by HIV-positive patients prior to ART initiation were estimated at urban primary healthcare facilities in South Africa. Costs included direct costs, indirect (productivity) costs, carer and coping costs (value of assets sold and money borrowed). The percentage of individual income spent on healthcare was calculated and compared by patient income tertiles and CD4 count strata.Results289 patients (69% female, mean age 37 (SD: 10) years, median CD4 317 (IQR: 138-494) cells/mm3) were interviewed. The total mean monthly cost of pre-ART care was US$15.71. Indirect costs accounted for $2.59 (16.49%) of this when time was valued using the patient's reported income. The mean monthly patient costs were $31.61, $12.78, $12.65 and $11.93 for those with a CD4 count 500 cells/mm3 respectively. The percentage of individual income spent on healthcare was 7.25% for those with a CD4 count 500 cells/mm3.ConclusionsDespite the provision of charge-free services at public clinics, care prior to ART initiation can be costly, particularly for the poor and unemployed. Our study adds to the growing body of evidence that highlights the need to consider policies to reduce the economic barriers to HIV service access, particularly for low income or unwell patient groups, such as improving access to disability grants.
- Subjects :
- Male
RNA viruses
Financial Management
Economics
Social Sciences
HIV Infections
Pathology and Laboratory Medicine
South Africa
Cost of Illness
Immunodeficiency Viruses
Antiretroviral Therapy, Highly Active
Medicine and Health Sciences
Salaries
Economics of Poverty
Public and Occupational Health
Prospective Studies
health care economics and organizations
Human Capital
Vaccination and Immunization
Socioeconomic Aspects of Health
Medical Microbiology
Viral Pathogens
Viruses
Income
Medicine
Female
Pathogens
Research Article
Adult
Anti-HIV Agents
Science
Immunology
Antiretroviral Therapy
Microbiology
Health Economics
Antiviral Therapy
Retroviruses
Indirect Costs
Humans
Microbial Pathogens
Primary Health Care
Lentivirus
Organisms
Biology and Life Sciences
HIV
Health Care
Cross-Sectional Studies
Labor Economics
Minimum Wage
Preventive Medicine
Finance
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 14
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.pmid.dedup....37c54c9329574a698935b7a25d54864d