Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.

BACKGROUND:Viral load testing is considered the gold standard for monitoring HIV treatment; however, given its high cost, some patients cannot afford viral load testing if this testing is not subsidized. Since foreign aid for HIV/AIDS in Vietnam is rapidly decreasing, we sought to assess willingness...

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Main Authors: Quyen Le Thi Nguyen, Long Hoang Nguyen, Bach Xuan Tran, Huong Thi Thu Phan, Huong Thi Le, Hinh Duc Nguyen, Tho Dinh Tran, Cuong Duy Do, Cuong Manh Nguyen, Vu Thi Minh Thuc, Carl Latkin, Melvyn W B Zhang, Roger C M Ho
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5310871?pdf=render
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spelling doaj-c6298c3ed1114dfe88d11b9212e6365c2020-11-25T02:48:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01122e017205010.1371/journal.pone.0172050Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.Quyen Le Thi NguyenLong Hoang NguyenBach Xuan TranHuong Thi Thu PhanHuong Thi LeHinh Duc NguyenTho Dinh TranCuong Duy DoCuong Manh NguyenVu Thi Minh ThucCarl LatkinMelvyn W B ZhangRoger C M HoBACKGROUND:Viral load testing is considered the gold standard for monitoring HIV treatment; however, given its high cost, some patients cannot afford viral load testing if this testing is not subsidized. Since foreign aid for HIV/AIDS in Vietnam is rapidly decreasing, we sought to assess willingness to pay (WTP) for viral load and CD4 cell count tests among HIV-positive patients, and identified factors that might inform future co-payment schemes. METHODS:A multi-site cross-sectional survey was conducted with 1133 HIV-positive patients on antiretroviral therapy (ART) in Hanoi and Nam Dinh. Patients' health insurance coverage, quality of life, and history of illicit drug use were assessed. A contingent valuation approach was employed to measure patients' WTP for CD4 cell count and viral load testing. RESULTS:HIV-positive patients receiving ART at provincial sites reported more difficulty obtaining health insurance (HI) and had the overall the poorest quality of life. Most patients (90.9%) were willing to pay for CD4 cell count testing; here, the mean WTP was valued at US$8.2 (95%CI = 7.6-8.8 US$) per test. Most patients (87.3%) were also willing to pay for viral load testing; here, mean WTP was valued at US$18.6 (95%CI = 16.3-20.9 US$) per test. High income, high education level, and hospitalization were positively associated with WTP, while co-morbidity with psychiatric symptoms and trouble paying for health insurance were both negatively related to WTP. CONCLUSIONS:These findings raise concerns that HIV-positive patients in Vietnam might have low WTP for CD4 cell count and viral load testing. This means that without foreign financial subsidies, many of these patients would likely go without these important tests. Treating psychiatric co-morbidities, promoting healthcare services utilization, and removing barriers to accessing health insurance may increase WTP for monitoring of HIV/AIDS treatment among HIV+-positive Vietnamese patients.http://europepmc.org/articles/PMC5310871?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Quyen Le Thi Nguyen
Long Hoang Nguyen
Bach Xuan Tran
Huong Thi Thu Phan
Huong Thi Le
Hinh Duc Nguyen
Tho Dinh Tran
Cuong Duy Do
Cuong Manh Nguyen
Vu Thi Minh Thuc
Carl Latkin
Melvyn W B Zhang
Roger C M Ho
spellingShingle Quyen Le Thi Nguyen
Long Hoang Nguyen
Bach Xuan Tran
Huong Thi Thu Phan
Huong Thi Le
Hinh Duc Nguyen
Tho Dinh Tran
Cuong Duy Do
Cuong Manh Nguyen
Vu Thi Minh Thuc
Carl Latkin
Melvyn W B Zhang
Roger C M Ho
Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.
PLoS ONE
author_facet Quyen Le Thi Nguyen
Long Hoang Nguyen
Bach Xuan Tran
Huong Thi Thu Phan
Huong Thi Le
Hinh Duc Nguyen
Tho Dinh Tran
Cuong Duy Do
Cuong Manh Nguyen
Vu Thi Minh Thuc
Carl Latkin
Melvyn W B Zhang
Roger C M Ho
author_sort Quyen Le Thi Nguyen
title Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.
title_short Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.
title_full Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.
title_fullStr Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.
title_full_unstemmed Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.
title_sort co-financing for viral load monitoring during the course of antiretroviral therapy among patients with hiv/aids in vietnam: a contingent valuation survey.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2017-01-01
description BACKGROUND:Viral load testing is considered the gold standard for monitoring HIV treatment; however, given its high cost, some patients cannot afford viral load testing if this testing is not subsidized. Since foreign aid for HIV/AIDS in Vietnam is rapidly decreasing, we sought to assess willingness to pay (WTP) for viral load and CD4 cell count tests among HIV-positive patients, and identified factors that might inform future co-payment schemes. METHODS:A multi-site cross-sectional survey was conducted with 1133 HIV-positive patients on antiretroviral therapy (ART) in Hanoi and Nam Dinh. Patients' health insurance coverage, quality of life, and history of illicit drug use were assessed. A contingent valuation approach was employed to measure patients' WTP for CD4 cell count and viral load testing. RESULTS:HIV-positive patients receiving ART at provincial sites reported more difficulty obtaining health insurance (HI) and had the overall the poorest quality of life. Most patients (90.9%) were willing to pay for CD4 cell count testing; here, the mean WTP was valued at US$8.2 (95%CI = 7.6-8.8 US$) per test. Most patients (87.3%) were also willing to pay for viral load testing; here, mean WTP was valued at US$18.6 (95%CI = 16.3-20.9 US$) per test. High income, high education level, and hospitalization were positively associated with WTP, while co-morbidity with psychiatric symptoms and trouble paying for health insurance were both negatively related to WTP. CONCLUSIONS:These findings raise concerns that HIV-positive patients in Vietnam might have low WTP for CD4 cell count and viral load testing. This means that without foreign financial subsidies, many of these patients would likely go without these important tests. Treating psychiatric co-morbidities, promoting healthcare services utilization, and removing barriers to accessing health insurance may increase WTP for monitoring of HIV/AIDS treatment among HIV+-positive Vietnamese patients.
url http://europepmc.org/articles/PMC5310871?pdf=render
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