Understanding patient-level costs of weekly isoniazid-rifapentine (3HP) among people living with HIV in Uganda
METHODS: We surveyed PWH who initiated 3HP at a large urban HIV/AIDS clinic in Kampala, Uganda, as part of a larger trial. We estimated the cost of one 3HP visit from the patient perspective, including both out-of-pocket costs and estimated lost wages. Costs were reported in 2021 Ugandan shillings (UGX) and US dollars (USD; USD1 = UGX3,587)
RESULTS: The survey included 1,655 PWH. The median participant cost of one clinic visit was UGX19,200 (USD5.36), or 38.5% of the median weekly income. Per visit, the cost of transportation was the largest component (median: UGX10,000/USD2.79), followed by lost income (median: UGX4,200/USD1.16) and food (median: UGX2,000/USD0.56). Men reported greater income loss than women (median: UGX6,400/USD1.79 vs. UGX3,300/USD0.93), and participants who lived further than a 30-minute drive to the clinic had higher transportation costs than others (median: UGX14,000/USD3.90 vs. UGX8,000/USD2.23).
CONCLUSION: Patient-level costs to receive 3HP accounted for over one-third of weekly income. Patient-centered approaches to averting or defraying these costs are needed.
Keywords: cost analysis; human immunodeficiency virus; people living with HIV; tuberculosis preventive treatment
Document Type: Research Article
Affiliations: 1: Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA 2: Infectious Diseases Research Collaboration, Kampala, Uganda 3: Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA 4: Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA 5: Child Health and Development Centre, Makerere University College of Health Sciences, Kampala, Uganda 6: Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda 7: Infectious Diseases Research Collaboration, Kampala, Uganda, Department of Internal Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda 8: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea 9: Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda 10: Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda, Department of Internal Medicine Clinical Epidemiology Unit, Makerere University College of Health Science, Kampala, Uganda 11: Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA, Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda, Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, CA, USA 12: Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA 13: Infectious Diseases Research Collaboration, Kampala, Uganda, Department of Internal Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda, Makerere University Joint AIDS Program, Kampala, Uganda
Publication date: June 1, 2023
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