ArticlePLOS global public health2024
Current out of pocket care costs among HIV and hypertension co-morbid patients in urban and peri-urban Uganda.
Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Mixed methods assessment of an integrated hypertension and HIV care model: Acceptability, feasibility, and clinical outcomes at primary healthcare clinics in Wakiso District, Uganda.Journal of public health in Africa · 2026Article
- Examining the potential of mobile money-based health insurance for people living with HIV and hypertension or diabetes in Uganda.Frontiers in health services · 2026Article
- Implementation strategies to integrate HIV and hypertension care in Kampala and Wakiso districts, Uganda: study protocol for a stepped wedge cluster randomized trial (PULESA-Uganda).BMC health services research · 2025Article
- Exploring the facilitators and barriers to achieving universal health coverage in Uganda: a qualitative study of the free healthcare policy.Health research policy and systems · 2025Article
- Household economic burden of managing people living with HIV and comorbidities of hypertension and diabetes in La Nkwantanang-Madina Municipality, Ghana.PLOS global public health · 2025Article
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Authors and funding
15 authors.
Funding
Abstract
backgroundDespite improvements to the cascade of HIV care in East Africa, access to care for non-communicable disease co-morbidities like hypertension (HTN) remains a persistent problem. The integration of care for these conditions presents an opportunity to achieve efficiencies in delivery as well as decrease overall costs for patients. This study aims to build evidence on the burden of current out-of-pocket costs of care among HIV-HTN co-morbid patients.
methodsWe administered a pre-tested, cross-sectional, out-of-pocket cost survey to 94 co-morbid patients receiving HIV care from 10 clinics in the Wakiso and Kampala districts of Uganda from June to November 2021. The survey assessed socio-demographic characteristics, direct medical costs (e.g., medications, consultations), indirect costs (e.g., transport, food, caregiving), and economic costs (i.e., foregone income) associated with seeking HIV and HTN care, as well as possible predictors of monthly care costs. Patients were sampled both during a government-imposed nation-wide full COVID-19 lockdown (n = 30) and after it was partially lifted (n = 64).
resultsMedian HIV care costs constitute between 2.7 and 4.0% of median monthly household income, while HTN care costs are between 7.1 to 7.9%. For just under half of our sample, the median monthly cost of HTN care is more than 10% of household income, and more than a quarter of patients report borrowing money or selling assets to cover costs. We observe uniformly lower reported costs of care for both conditions under full COVID-19 lockdown, suggesting that access to care was limited. The main predictors of monthly HIV and HTN care costs varied by disease and costing perspective.
conclusionsPatient out of pocket costs of care for HIV and HTN were substantial, but significantly lower during the 2021 full COVID-19 lockdown in Uganda. New strategies such as service integration need to be explored to reduce these costs.
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