Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey
Viral
load testing is considered the gold standard for monitoring HIV treatment;
however, given its high cost, some patients cannot afford viral load testing if
this testing is not subsidized.
Since
foreign aid for HIV/AIDS in Vietnam is rapidly decreasing, we sought to assess
willingness to pay (WTP) for viral load and CD4 cell count tests among
HIV-positive patients, and identified factors that might inform future
co-payment schemes.
A
multi-site cross-sectional survey was conducted with 1133 HIV-positive patients
on antiretroviral therapy (ART) in Hanoi and Nam Dinh.
Patients'
health insurance coverage, quality of life, and history of illicit drug use
were assessed.
A
contingent valuation approach was employed to measure patients' WTP for CD4
cell count and viral load testing. HIV-positive patients receiving ART at
provincial sites reported more difficulty obtaining health insurance (HI) and
had the overall the poorest quality of life.
Most
patients (90.9%) were willing to pay for CD4 cell count testing; here, the mean
WTP was valued at US$8.2 (95% CI = 7.6-8.8 US$) per test. Most patients (87.3%)
were also willing to pay for viral load testing; here, mean WTP was valued at
US$18.6 (95% CI = 16.3-20.9 US$) per test.
High
income, high education level, and hospitalization were positively associated
with WTP, while co-morbidity with psychiatric symptoms and trouble paying for
health insurance were both negatively related to WTP.
These
findings raise concerns that HIV-positive patients in Vietnam might have low
WTP for CD4 cell count and viral load testing.
This
means that without foreign financial subsidies, many of these patients would
likely go without these important tests.
Treating
psychiatric co-morbidities, promoting healthcare services utilization, and
removing barriers to accessing health insurance may increase WTP for monitoring
of HIV/AIDS treatment among HIV+-positive Vietnamese patients.
Title:
| Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey | |
| Authors: | Nguyen Thi Quyen Le Nguyen Long Hoang Tran Bach Xuan |
| Keywords: | WILLINGNESS-TO-PAY ACQUIRED-IMMUNODEFICIENCY-SYNDROME ATTITUDES HIV COHORT RISK AIDS |
| Issue Date: | 2017 |
| Publisher: | PUBLIC LIBRARY SCIENCE, 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA |
| Citation: | ISIKNOWLEDGE |
| Abstract: | Viral load testing is considered the gold standard for monitoring HIV treatment; however, given its high cost, some patients cannot afford viral load testing if this testing is not subsidized. Since foreign aid for HIV/AIDS in Vietnam is rapidly decreasing, we sought to assess willingness to pay (WTP) for viral load and CD4 cell count tests among HIV-positive patients, and identified factors that might inform future co-payment schemes. A multi-site cross-sectional survey was conducted with 1133 HIV-positive patients on antiretroviral therapy (ART) in Hanoi and Nam Dinh. Patients' health insurance coverage, quality of life, and history of illicit drug use were assessed. A contingent valuation approach was employed to measure patients' WTP for CD4 cell count and viral load testing. HIV-positive patients receiving ART at provincial sites reported more difficulty obtaining health insurance (HI) and had the overall the poorest quality of life. Most patients (90.9%) were willing to pay for CD4 cell count testing; here, the mean WTP was valued at US$8.2 (95% CI = 7.6-8.8 US$) per test. Most patients (87.3%) were also willing to pay for viral load testing; here, mean WTP was valued at US$18.6 (95% CI = 16.3-20.9 US$) per test. High income, high education level, and hospitalization were positively associated with WTP, while co-morbidity with psychiatric symptoms and trouble paying for health insurance were both negatively related to WTP. These findings raise concerns that HIV-positive patients in Vietnam might have low WTP for CD4 cell count and viral load testing. This means that without foreign financial subsidies, many of these patients would likely go without these important tests. Treating psychiatric co-morbidities, promoting healthcare services utilization, and removing barriers to accessing health insurance may increase WTP for monitoring of HIV/AIDS treatment among HIV+-positive Vietnamese patients. |
| Description: | TNS07070 ; PLOS ONE Volume: 12 Issue: 2 Article Number: e0172050 Published: FEB 15 2017 |
| URI: | http://repository.vnu.edu.vn/handle/VNU_123/29707 |
| ISSN: | 1932-6203 |
| Appears in Collections: | Bài báo của ĐHQGHN trong Web of Science |
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