Costs of accessing HIV testing services among rural Malawi communities

Costs of accessing HIV testing services among rural Malawi communities
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DOI:
10.1080/09540121.2018.1479032
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发表时间:
2018-07-08
期刊:
影响因子:
1.7
通讯作者:
Terris-Prestholt F
Terris-Prestholt F
中科院分区:
医学4区
文献类型:
--
作者:
Sande L;Maheswaran H;Mangenah C;Mwenge L;Indravudh P;Mkandawire P;Ahmed N;d’Elbee M;Johnson C;Hatzold K;Corbett EL;Neuman M;Terris-Prestholt F

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在马拉维,艾滋病毒检测是免费的,但使用者仍可能承担费用,这可能会阻止或推迟他们获得这些服务。我们试图确定和量化这些费用在马拉维的艾滋病毒检测服务的客户。我们询问了参与一项整群随机试验的社区居民,该试验调查了艾滋病毒自我检测对他们过去的艾滋病毒检测经验以及获得艾滋病毒检测所产生的直接非医疗和间接费用的影响。我们招募了749名参与者,他们最近一次HIV检测是在过去12个月内。获得检测的平均总成本为2.45美元(95%CI:2.11 - 2.70美元)。男性的成本(3.81美元; 95%可信区间:2.91 - 4.50美元)高于女性(1.83美元; 95%可信区间:1.61 - 2.00美元)。两部分多变量回归分析的结果表明,年龄,检测地点,检测时间,访问专门用于艾滋病毒检测的设施和居住区显着影响测试费用的可能性。此外,性别、财富、年龄、教育和居住区与重要的用户成本有关。
HIV testing is free in Malawi, but users may still incur costs that can deter or delay them accessing these services. We sought to identify and quantify these costs among HIV testing service clients in Malawi. We asked residents of communities participating in a cluster randomised trial investigating the impact of HIV self-testing about their past HIV testing experiences and the direct non-medical and indirect costs incurred to access HIV testing. We recruited 749 participants whose most recent HIV test was within the past 12 months. The mean total cost to access testing was US$2.45 (95%CI: US$2.11–US$2.70). Men incurred higher costs (US$3.81; 95%CI: US$2.91–US$4.50) than women (US$1.83; 95%CI: US$1.61–US$2.00). Results from a two-part multivariable regression analysis suggest that age, testing location, time taken to test, visiting a facility specifically for an HIV test and district of residence significantly affected the odds of incurring costs to testing. In addition, gender, wealth, age, education and district of residence were associated with significant user costs.
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