Catastrophic Health Expenditure Amongst People Living with HIV/AIDS Availing Antiretroviral Treatment Services at Two Tertiary Care Health Facilities in District of Northern India

Authors

  • Mukesh Shukla K.G.M.U, Lucknow
  • Monika Agarwal K.G.M.U, Lucknow
  • Jai Vir Singh K.G.M.U, Lucknow
  • Anil Kumar Tripathi K.G.M.U, Lucknow
  • Anand Kumar Srivastava K.G.M.U, Lucknow
  • Vijay Kumar Singh K.G.M.U, Lucknow

Keywords:

PLHA, Antiretroviral Therapy, Out-of-pocket expenditure, Catastrophic health expenditure

Abstract

Introduction: The present study aimed to estimate the out of pocket expenditure incurred and the various factors determining catastrophic health expenditure while receiving ART services.

Methods: A hospital based cross sectional study was conducted at two tertiary care hospitals of Lucknow for a period of six months. A total of 322 HIV-positive patients were interviewed face to face about their various expenses during the visit to ART centre.

Result: Mean out of pocket expenditure of the patients attending ART centre INR 312.26 ± 20.06. Catastrophic out-of-pocket ex- penditure incurred in about one-fifth (16.1%) patients attending the ART centre. Multiple logistic regression revealed distance trav- elled more than hundred kilometres to reach ART centre (OR 9.59; 95% CI 1.43–64.267; p = 0.02) and lower socioeconomic class (OR 10.31; 95% CI 2.30–44.58; p = 0.00) were found to be independent predictors of catastrophic out-of-pocket expenditure.

Conclusions: Decentralisation of ART programme up to grass root level, integration of HIV/AIDS-related services into primary health care services and bridging of the loop holes like effective convening of various government benefit schemes to patients dur- ing their visit to ART centre and there by promoting utilisation could reduce their financial burden for care and treatment.

References

WHO | HIV/AIDS: HIV/AIDS. Global situation and trends 2013. Available from : http/www.who.int/gho/hiv/en.html. Assessed on Nov 21st, 2014.

Global update on the Health Sector Response to HIV, 2014. Available from: http://www.who.int/hiv/ pub/global-update.pdf. Assessed on Jul 31st, 2015.

Government of India, Ministry of Health and Family Welfare, National AIDS Control Organisation. Pro- gramme Implementation Plan (PIP), NACP-III (2007-12). Available from: www.nacoonline.org. Assessed on Jan 1st, 2015.

Desclaux A. Equality in access to AIDS treatment in Af- rica: Pitfalls among achievements. Available from: las- siques.uqac.ca/ contemporains/ Desclaux alice/equity in access to AIDS/equity in access to AIDS.pdf. Assessed on Nov 21st , 2014.

Laniece I, Diop K, Desclaux A, Sow K, Ciss B. Determi- nants of adherence among adults receiving antiretroviral drugs in Senegal (ANRS 1215 Cohort study). Antiviral Therapy 2003: 8: S501-S502.

Nwokike JI. Baseline data and predictors of adherence to antiretroviral therapy in Maun General Hospital (MGH), Maun, Botswana. Antiviral Therapy 2003: 8:S396.

Weiser S, Wolfe W, Bangsberg D, Thior I, Gilbert P. Bar- riers to antiretroviral adherence for patients living with HIV infection and AIDS in Botswana. J Acquire Immune Deficiency Syndrome 2003: 34: 281-288.

National Sample Survey Organization. National Sample Survey 1996, Report No 441, 52nd Round, New Delhi: National Sample Survey Organization ,Govt of India; 1998.

Mhaskar R, Alandikar V, Emmauel P, Djulbegovic B, Pa- tel S, Patel A, et al. Adherence to antiretroviral therapy in India: Asystematic review and meta-analysis. Indian J Community Medicine 2013;38:74-82.

Lwanga SK. Sample size determination in health studies’ a practical manual , 1st edition. England : World Health Organization ;1991.p 2.

Catastrophic Health Expenditure and Poor in India: New Evidence from a Nation-wide Survey: Available from : paa2012.princeton.edu/papers/121467. Assessed on Aug 24th ,2014.

Bach X. Tran, Anh T. Duong, Long T. Nguyen3, Jongnam Hwang, Binh T. Nguyen, Quynh T. Nguyen,Vuong M. Nong, Phu X. Vu6 and Arto Ohinmaa. Financial burden of health care for HIV/AIDS patients in Vietnam. Tropi- cal Medicine and International Health doi:10.1111/tmi.12032 volume 18 no 2 pp 212–218 febru- ary 2011.

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Published

2015-09-30

How to Cite

1.
Shukla M, Agarwal M, Singh JV, Tripathi AK, Srivastava AK, Singh VK. Catastrophic Health Expenditure Amongst People Living with HIV/AIDS Availing Antiretroviral Treatment Services at Two Tertiary Care Health Facilities in District of Northern India. Natl J Community Med [Internet]. 2015 Sep. 30 [cited 2024 Mar. 29];6(03):323-8. Available from: https://njcmindia.com/index.php/file/article/view/1201

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Original Research Articles