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Title: Co-financing for Viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey
Authors: Nguyen Q.L.T.
Nguyen L.H.
Tran B.X.
Phan H.T.T.
Le H.T.
Nguyen H.D.
Tran T.D.
Do C.D.
Nguyen C.M.
Thuc V.T.M.
Latkin C.
Zhang M.W.B. 
Ho R.C.M. 
Keywords: antiretrovirus agent
illicit drug
antiretrovirus agent
acquired immune deficiency syndrome
antiretroviral therapy
CD4 lymphocyte count
controlled study
cross-sectional study
drug abuse
financial management
health care cost
health insurance
human cell
Human immunodeficiency virus infection
major clinical study
medical history
mental disease
middle aged
patient monitoring
quality of life
Viet Nam
virus load
young adult
Acquired Immunodeficiency Syndrome
financial management
HIV Infections
Human immunodeficiency virus
mental health
patient attitude
social class
virus load
Acquired Immunodeficiency Syndrome
Anti-Retroviral Agents
CD4 Lymphocyte Count
Cross-Sectional Studies
Financing, Personal
HIV Infections
Insurance, Health
Mental Health
Middle Aged
Patient Acceptance of Health Care
Quality of Life
Social Class
Surveys and Questionnaires
Viral Load
Young Adult
Issue Date: 2017
Publisher: Public Library of Science
Citation: Nguyen Q.L.T., Nguyen L.H., Tran B.X., Phan H.T.T., Le H.T., Nguyen H.D., Tran T.D., Do C.D., Nguyen C.M., Thuc V.T.M., Latkin C., Zhang M.W.B., Ho R.C.M. (2017). 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 12 (2) : e0172050. ScholarBank@NUS Repository.
Abstract: 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. © 2017 Nguyen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
ISSN: 19326203
DOI: 10.1371/journal.pone.0172050
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