Financial burdens of HIV and chronic disease on people living with HIV in Côte d'Ivoire: A cross-sectional out-of-pocket expenditure study.
<h4>Background</h4>Although people living with HIV in Côte d'Ivoire receive antiretroviral therapy (ART) at no cost, other out-of-pocket (OOP) spending related to health can still create a barrier to care.<h4>Methods</h4>A convenience sample of 400 adults living with HIV...
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2021
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oai:doaj.org-article:c3b05e228fc74e5e9bebb460871f49852021-12-02T20:08:57ZFinancial burdens of HIV and chronic disease on people living with HIV in Côte d'Ivoire: A cross-sectional out-of-pocket expenditure study.1932-620310.1371/journal.pone.0255074https://doaj.org/article/c3b05e228fc74e5e9bebb460871f49852021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255074https://doaj.org/toc/1932-6203<h4>Background</h4>Although people living with HIV in Côte d'Ivoire receive antiretroviral therapy (ART) at no cost, other out-of-pocket (OOP) spending related to health can still create a barrier to care.<h4>Methods</h4>A convenience sample of 400 adults living with HIV for at least 1 year in Côte d'Ivoire completed a survey on their health spending for HIV and chronic non-communicable diseases (NCDs). In addition to descriptive statistics, we performed simple linear regression analyses with bootstrapped 95% confidence intervals.<h4>Findings</h4>365 participants (91%) reported OOP spending for HIV care, with a median of $16/year (IQR 5-48). 34% of participants reported direct costs with a median of $2/year (IQR 1-41). No participants reported user fees for HIV services. 87% of participants reported indirect costs, with a median of $17/year (IQR 7-41). 102 participants (26%) reported at least 1 NCD. Of these, 80 (78%) reported OOP spending for NCD care, with a median of $50/year (IQR 6-107). 76 participants (95%) with both HIV and NCDs reported direct costs, and 48% reported paying user fees for NCD services. Participants had missed a median of 2 HIV appointments in the past year (IQR 2-3). Higher OOP costs were not associated with the number of HIV appointments missed. 21% of participants reported spending over 10% of household income on HIV and/or NCD care.<h4>Discussion and conclusions</h4>Despite the availability of free ART, most participants reported OOP spending. OOP costs were much higher for participants with co-morbid NCDs.Rachel D StelmachMiriam RabkinKouame AboIrma AhobaMahena Gildas AnagoRodrigo BoccaneraHermann BrouRebecca FlueckigerKieran HartsoughMartin MsukwaJennifer ZechFelicity YoungRachel NugentPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0255074 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Rachel D Stelmach Miriam Rabkin Kouame Abo Irma Ahoba Mahena Gildas Anago Rodrigo Boccanera Hermann Brou Rebecca Flueckiger Kieran Hartsough Martin Msukwa Jennifer Zech Felicity Young Rachel Nugent Financial burdens of HIV and chronic disease on people living with HIV in Côte d'Ivoire: A cross-sectional out-of-pocket expenditure study. |
| description |
<h4>Background</h4>Although people living with HIV in Côte d'Ivoire receive antiretroviral therapy (ART) at no cost, other out-of-pocket (OOP) spending related to health can still create a barrier to care.<h4>Methods</h4>A convenience sample of 400 adults living with HIV for at least 1 year in Côte d'Ivoire completed a survey on their health spending for HIV and chronic non-communicable diseases (NCDs). In addition to descriptive statistics, we performed simple linear regression analyses with bootstrapped 95% confidence intervals.<h4>Findings</h4>365 participants (91%) reported OOP spending for HIV care, with a median of $16/year (IQR 5-48). 34% of participants reported direct costs with a median of $2/year (IQR 1-41). No participants reported user fees for HIV services. 87% of participants reported indirect costs, with a median of $17/year (IQR 7-41). 102 participants (26%) reported at least 1 NCD. Of these, 80 (78%) reported OOP spending for NCD care, with a median of $50/year (IQR 6-107). 76 participants (95%) with both HIV and NCDs reported direct costs, and 48% reported paying user fees for NCD services. Participants had missed a median of 2 HIV appointments in the past year (IQR 2-3). Higher OOP costs were not associated with the number of HIV appointments missed. 21% of participants reported spending over 10% of household income on HIV and/or NCD care.<h4>Discussion and conclusions</h4>Despite the availability of free ART, most participants reported OOP spending. OOP costs were much higher for participants with co-morbid NCDs. |
| format |
article |
| author |
Rachel D Stelmach Miriam Rabkin Kouame Abo Irma Ahoba Mahena Gildas Anago Rodrigo Boccanera Hermann Brou Rebecca Flueckiger Kieran Hartsough Martin Msukwa Jennifer Zech Felicity Young Rachel Nugent |
| author_facet |
Rachel D Stelmach Miriam Rabkin Kouame Abo Irma Ahoba Mahena Gildas Anago Rodrigo Boccanera Hermann Brou Rebecca Flueckiger Kieran Hartsough Martin Msukwa Jennifer Zech Felicity Young Rachel Nugent |
| author_sort |
Rachel D Stelmach |
| title |
Financial burdens of HIV and chronic disease on people living with HIV in Côte d'Ivoire: A cross-sectional out-of-pocket expenditure study. |
| title_short |
Financial burdens of HIV and chronic disease on people living with HIV in Côte d'Ivoire: A cross-sectional out-of-pocket expenditure study. |
| title_full |
Financial burdens of HIV and chronic disease on people living with HIV in Côte d'Ivoire: A cross-sectional out-of-pocket expenditure study. |
| title_fullStr |
Financial burdens of HIV and chronic disease on people living with HIV in Côte d'Ivoire: A cross-sectional out-of-pocket expenditure study. |
| title_full_unstemmed |
Financial burdens of HIV and chronic disease on people living with HIV in Côte d'Ivoire: A cross-sectional out-of-pocket expenditure study. |
| title_sort |
financial burdens of hiv and chronic disease on people living with hiv in côte d'ivoire: a cross-sectional out-of-pocket expenditure study. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/c3b05e228fc74e5e9bebb460871f4985 |
| work_keys_str_mv |
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| _version_ |
1718375148364496896 |