Owusu Richmond, Degbor Esther Esi, Otoo Desmond Dzidzornu, Annan Ruby A M
Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Accra, Ghana.
PLOS Glob Public Health. 2025 Apr 7;5(4):e0004371. doi: 10.1371/journal.pgph.0004371. eCollection 2025.
Managing HIV alongside chronic conditions such as hypertension and diabetes present significant economic challenges for households, especially in low-and middle-income countries. These chronic diseases not only reduce the quality of life of people living with HIV (PLHIV) but also further increase their economic burden. This study seeks to examine the economic burden of managing PLHIV with hypertension and diabetes comorbidities. The cross-sectional cost-of-illness study used quantitative data gathered from 56 PLHIV with hypertension and/or diabetes receiving ART at two Polyclinics and the Pentecost Hospital in the La Nkwantanang-Madina Municipality. A structured questionnaire was used to collect data on patients' socio-demographic characteristics, direct, indirect, and intangible costs between September to December 2023. Data was analyzed and presented descriptively.The total economic cost of PLHIV managing comorbidities was GHS11,892.11 (USD 1,022.54) with a direct cost of GHS10,739.00 (US$ 923.39) accounting for 90.3% and indirect cost of GHS 1,153.14 (US$ 99.15) accounting for 9.7% over 6 months. Direct medical costs constituted 83.1% of total costs with the cost of medicines being the largest cost component. There was a significant difference between the total costs across the comorbidities (X2=8.58, p = 0.0137). Approximately 45.24% of the average annual income per person was spent on managing comorbidities in PLHIV. About 89% of participants reported a low intangible cost burden. This study reveals the significant economic burden on households managing HIV with hypertension and diabetes comorbidities. Direct costs driven by medication expenses constituted the majority of the burden, while productivity losses compounded indirect costs. Despite widespread health insurance coverage, substantial out-of-pocket payments are made in the management of these comorbidities. The findings emphasize the need for integrated healthcare strategies to address both communicable and non-communicable diseases, especially in low-income settings, and policies to reduce financial barriers. Studies should explore long-term burden and strategies to alleviate the economic impact on vulnerable populations.
在同时应对高血压和糖尿病等慢性病的情况下管理艾滋病毒，给家庭带来了巨大的经济挑战，尤其是在低收入和中等收入国家。这些慢性病不仅降低了艾滋病毒感染者（PLHIV）的生活质量，还进一步增加了他们的经济负担。本研究旨在探讨管理合并高血压和糖尿病的艾滋病毒感染者的经济负担。这项横断面疾病成本研究使用了从拉恩夸坦南 - 马迪纳市的两家综合诊所和五旬节医院接受抗逆转录病毒治疗的56名合并高血压和/或糖尿病的艾滋病毒感染者收集的定量数据。2023年9月至12月期间，使用结构化问卷收集了患者的社会人口学特征、直接、间接和无形成本的数据。对数据进行了描述性分析。合并症艾滋病毒感染者的总经济成本为11,892.11加纳塞地（1,022.54美元），其中直接成本为10,739.00加纳塞地（923.39美元），占90.3%，间接成本为1,153.14加纳塞地（99.15美元），占6个月期间的9.7%。直接医疗成本占总成本的83.1%，药品成本是最大的成本组成部分。不同合并症的总成本之间存在显著差异（X2 = 8.58，p = 0.0137）。艾滋病毒感染者管理合并症的费用约占人均年收入的45.24%。约89%的参与者报告无形成本负担较低。本研究揭示了管理合并高血压和糖尿病的艾滋病毒感染者的家庭所承受的巨大经济负担。由药物费用驱动的直接成本构成了负担的大部分，而生产力损失加剧了间接成本。尽管医疗保险覆盖范围广泛，但在管理这些合并症时仍需支付大量自付费用。研究结果强调需要综合医疗保健策略来应对传染病和非传染病，特别是在低收入环境中，以及需要制定政策以减少经济障碍。研究应探索长期负担以及减轻对弱势群体经济影响的策略。
