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

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.