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Understanding patient-level costs of weekly isoniazid-rifapentine (3HP) among people living with HIV in Uganda

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Authors

Sung, J.; Musinguzi, A.; Kadota, J.L.; Baik, Y.; Nabunje, J.; Welishe, F.; Bishop, O.; Berger, C.A.; Katahoire, A.; Nakitende, A.; Nakimuli, J.; Akello, L.; Kasidi, J.R.; Kunihira, Tinka L.; Kamya, M.R.; Sohn, H.; Kiwanuka, N.; Katamba, A.; Cattamanchi, A.; Dowdy, D.W.; Semitala, F.C.

Issue Date
2023-04
Publisher
International Union Against Tuberculosis And Lung Disease/Union Internationale Contre la Tuberculose et les Maladies Respiratories
Citation
International Journal of Tuberculosis and Lung Disease, Vol.27 No.6, pp.458-464
Abstract
BACKGROUND: Twelve weeks of weekly isoniazid and rifapentine (3HP) prevents TB disease among people with HIV (PWH), but the costs to people of taking TB preventive treatment is not well described.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.
ISSN
1027-3719
URI
https://hdl.handle.net/10371/201735
DOI
https://doi.org/10.5588/ijtld.22.0679
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  • College of Medicine
  • Department of Human Systems Medicine
Research Area 결핵, 국제보건, 에이즈

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