Persistent Identifier
|
doi:10.11588/data/OYUCUZ |
Publication Date
|
2024-04-18 |
Title
| Out-of-pocket Expenses and Time Spent on Clinic Visits Among HIV Pre-exposure Prophylaxis Users and Other Clinic Attendees in Eswatini |
Author
| Kohler, Stefan (Heidelberg University, Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg, Germany and Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany) - ORCID: 0000-0003-1365-7506
Dalal, Shona (Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland) - ORCID: 0000-0003-1684-7452
Hettema, Anita (Clinton Health Access Initiative, Mbabane, Eswatini) - ORCID: 0000-0002-9764-2178
Matse, Sindy (Eswatini Ministry of Health, Mbabane, Eswatini)
Bärnighausen, Till (Heidelberg University, Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg, Germany) - ORCID: orcid.org/0000-0002-4182-4212
Paul, Nicolas (Heidelberg University, Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg, Germany) - ORCID: 0000-0003-2228-3980 |
Point of Contact
|
Use email button above to contact.
Kohler, Stefan (Heidelberg University, Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg, Germany) |
Description
| User costs constitute a barrier to the uptake of HIV pre-exposure prophylaxis (PrEP), but their magnitude appears rarely assessed. In this prospective observational study, we assessed self-reported out-of-pocket expenses (OOPE) and time spent on clinic visits during a PrEP demonstration project in Eswatini. At six public primary care clinics, 240 PrEP users and other clinic attendees were interviewed after a clinic visit. Among the 79.2% of clinic attendees reporting any medical OOPE (e.g., expenses for consultations or drugs) and/or non-medical OOPE (e.g., expenses for transport, food, or phone use), the median total OOPE was $1.36 (IQR 0.91-1.96). Non-medical OOPE occurred mostly due to transport expenses. The median travel time for a clinic visit was 1.0 h (IQR 0.67-2.0). The median time spent in the clinic was 2.0 h (IQR 1.15-3.0). The median opportunity cost of a clinic visit was $7.54 (IQR 5.42-11) when valuing time spent on a clinic visit with Eswatini's per-capita gross domestic product. Our findings can guide measures to reduce the user costs of PrEP in Eswatini and other contexts in which oral PrEP is provided through health care facilities. |
Subject
| Medicine, Health and Life Sciences |
Related Publication
| Kohler S, Dalal S, Hettema A, Matse S, Bärnighausen T, Paul N. Out-of-pocket expenses and time spent on clinic visits among HIV pre-exposure prophylaxis users and other clinic attendees in Eswatini. AIDS and Behavior 2023; 27: 1222–1233 doi: 10.1007/s10461-022-03859-3 https://doi.org/10.1007/s10461-022-03859-3 |
Funding Information
| World Health Organization: H9/181/R
U.S. Agency for International Development: U.S. President’s Emergency Plan for AIDS Relief |