为艾滋病毒治疗服务提供资金的可持续性：对尼日利亚患者愿意为治疗服务付费的横断面调查。

Sustainability of Funding for HIV Treatment Services: A Cross-Sectional Survey of Patients' Willingness to Pay for Treatment Services in Nigeria.

机构信息

Health Leadership Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.

National AIDS and Sexually Transmitted Illnesses Control Program, Federal Ministry of Health, Abuja, Nigeria.

出版信息

Glob Health Sci Pract. 2022 Apr 29;10(2). doi: 10.9745/GHSP-D-21-00550. Print 2022 Apr 28.

DOI:10.9745/GHSP-D-21-00550

PMID:35487556

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9053145/

Abstract

BACKGROUND

About 50% of individuals needing HIV treatment are unable to access required services primarily due to the inability of the Nigerian HIV treatment program to meet patient needs. We explored patient willingness to pay for HIV treatment, which can inform the feasibility of cost recovery through patient fees to contribute to the funding of HIV treatment services in Nigeria.

METHODS

We conducted a cross-sectional survey of 400 people living with HIV randomly selected from 15 health care facilities providing free HIV treatment services in 2 medium and high HIV burden states (Lagos, Enugu) and the Federal Capital Territory Abuja. We calculated the elasticity of the price that patients were willing to pay per month relative to the estimated current cost of providing HIV treatment services per patient and determined the patient coverage and potential cost recovery at each price point.

RESULTS

We found that 92% of patients were willing to pay for HIV treatment. The mean amount patients were willing to pay was 3,000 naira (US$7.50) per month with about 18% of patients willing to pay the current monthly price of 5000 naira (US$12.50). The availability of financial support from family and friends (odds ratio [OR]=14.209; =.001; 95% confidence interval [CI]=0.151, 0.285), lack of employment (OR=0.190; =.02; 95% CI=0.015, 0.202), monthly income (OR=2.476; <.001; 95% CI=84.698, 737.233), and change in monthly income (OR=2.015; <.001; 95% CI=0.003, 0.229) were associated with willingness to pay.

CONCLUSION

Many Nigerian patients are willing to contribute to funding for HIV treatment and this can enhance domestic funding for HIV treatment and equitable access to treatment through proper segmentation of patients based on willingness and capacity to pay. Measures must be put in place to reduce the cost of accessing HIV treatment and promote financial empowerment of people living with HIV to improve willingness to pay for treatment.

摘要

背景

大约 50%需要接受 HIV 治疗的人无法获得所需的服务，主要是因为尼日利亚的 HIV 治疗方案无法满足患者的需求。我们探讨了患者对 HIV 治疗的支付意愿，这可以为通过向患者收取费用来为尼日利亚的 HIV 治疗服务提供资金的可行性提供信息。

方法

我们对随机从 15 个提供免费 HIV 治疗服务的医疗机构中抽取的 400 名艾滋病毒感染者进行了横断面调查，这些医疗机构分别位于两个中高艾滋病毒负担州（拉各斯、埃努古）和联邦首都区阿布贾。我们计算了患者愿意每月支付的价格相对于估计的每位患者提供 HIV 治疗服务的当前成本的弹性，并确定了每个价格点的患者覆盖率和潜在成本回收。

结果

我们发现 92%的患者愿意支付 HIV 治疗费用。患者愿意支付的平均金额为每月 3000 奈拉（7.50 美元），约有 18%的患者愿意支付目前每月 5000 奈拉（12.50 美元）的价格。家庭和朋友的经济支持（比值比[OR]=14.209；=.001；95%置信区间[CI]=0.151，0.285）、失业（OR=0.190；=.02；95%CI=0.015，0.202）、月收入（OR=2.476；<.001；95%CI=84.698，737.233）和月收入变化（OR=2.015；<.001；95%CI=0.003，0.229）与支付意愿相关。