Why Ugandans shy away from HIV/AIDS medicine

Government is worried over the 200,000 Ugandans that are hiding away from accessing treatment for HIV/AIDS in the country, the Minister for Presidency Esther Mbayo has disclosed.

At least 1.4 million people have HIV/AIDs in Uganda of which 1.2 of them are on ARVs yet over 200,000 Ugandans can’t access drugs according to the report delivered today on the Status of HIV in Uganda with Emphasis on HIV Prevalence and ART Coverage in the Various Districts of the country.

Addressing the journalists in Kampala, Minister Mbayo says that 6.8% women and 4.2% men, 2.8% and 1.1%  for girls and boys respectively are infected with HIV/AIDs.

Now the Director General of Uganda Aids Commission Dr Musoba atributes the leading cause of HIV/AIDs to be through unprotected sex and multiple sexual partners which to him is easy to be controlled once every Ugandan corporate.

Dr Joshua Musinguzi, the Commissioner Aids Control Program in the Ministry of Health hints out to 60 percent of the 190,000 people who died of HIV/AIDs in 2019 being men.

The commission together with the health ministry are now devising new means to see that they get mostly men to test and have all those that test positive started on ARVs to have the virus suppressed as this will help scale down on the levels of transmission to the uninfected persons.

The costs of HIV care services and treatment report, in 12 Ugandan public and non-public facilities that provide HIV care and sup-port services were studied. The aims included: to determine the average annual unit cost per patient (adult and child) for specific HIV treatment, care and support services; to establish the key cost components or “drivers” of such HIV treatment, care and support services; to determine what costs are borne by patients (“out-of-pocket costs”) that are not incurred in a clinical facility; and to compare cost variation by level of service delivery.

Data was collected at the facility level on major cost elements, staffing, patient loads and services provided. These were used to estimate the per-patient costs, including for both anti-retro-viral therapy (ART) and non-ART patients.

The study covered both adult and pediatric patients. Patient-level information was also gathered on services received, physical functionality, socio-economic background characteristics and costs incurred by patients in receiving care.

Results showed that the annual facility-level cost of providing HIV treatment, care and support to adult HIV patients ranges from UGX 254,000 to UGX 824,000 ($116.28 to $376.20) across the 12 sites, with a median cost of UGX 567,000 ($258.78).1 When restricted to adults on ART, annualized costs ranged from UGX 403,000 to UGX 1,330,000 ($183.54 to $606.48), with a median of UGX 734,000 ($335.16).

For children, we found that costs ranged from UGX 190,000 to UGX 1,869,000 ($86.64 to $852.72), with a median cost of UGX 630,000 ($287.28). The main cost drivers for both adults and children are ARVs and laboratory tests. Among all adults, ARVs ac-count for some 51% of costs and for children ARVs account for 69%. For laboratory services the percentages are 21% and 16% respectively.

First-line drugs account for the largest share of ARVs. The study also found that among the facilities contacted, public hospitals had a higher cost per adult patient than did non-public, not-for-profit hospitals but only by around 12% (UGX 655,018 vs. UGX 582,894.) Public hospitals had lower staff costs per patient while laboratory costs were higher. By contrast public health centers have much lower per-patient costs than non-public health centers for adults (UGX 335,625 vs. UGX 512,073.)

The major factor here was much cheaper staffing costs in public health centers (UGX 28,850 vs. UGX 168,845.) Similar patterns were found for children. Regarding patients’ out-of-pocket expenses on transportation and the value of time lost in seeking and getting treatment for patients on ART, annualized adult costs were UGX 266,814 and for children UGX 174,090. The largest component of this cost was the value of time lost.