Author(s)

Ibrahim Jahun¹, Mustapha Mukhtar², Aminu Yakubu³, Musa Zakirai⁴, Bamidele Moyosola⁵, Ahmad Aliyu⁶, Abdulrazaq G. Habib⁷, Gambo Aliyu¹

¹National Agency for the Control of AIDS (NACA), Abuja, Nigeria.
²Department of Economics, Bayero University Kano, Kano, Nigeria.
³54gene Laboratories, Lekki Lagos, Nigeria.
⁴National Population Commission, Abuja, Nigeria.
⁵School of Global Health and Bioethics, EUCLID University, Banjul, The Gambia.
⁶Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria.
⁷Department of Medicine, Bayero University Kano, Kano, Nigeria.

Introduction: With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. Methods: Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. Results: Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). Conclusion/recommendation: Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.

PLHIV, HIV Program Sustainability, HIV Out of Pocket Payments, Catastrophic HIV Expenditure

Jahun, I. , Mukhtar, M. , Yakubu, A. , Zakirai, M. , Moyosola, B. , Aliyu, A. , Habib, A. and Aliyu, G. (2021) Assessment of the Affordability of Out-of-Pocket Payments among Some Selected People Living with HIV in Kano, Nigeria. World Journal of AIDS, 11, 71-83. doi: 10.4236/wja.2021.112007.