RT Journal Article SR Electronic T1 Sustainability of Funding for HIV Treatment Services: A Cross-Sectional Survey of Patients' Willingness to Pay for Treatment Services in Nigeria JF Global Health: Science and Practice JO GLOB HEALTH SCI PRACT FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs SP e2100550 DO 10.9745/GHSP-D-21-00550 VO 10 IS 2 A1 Olawale Durosinmi-Etti A1 Bruce Fried A1 Karine Dubé A1 Sean Sylvia A1 Sandra Greene A1 Akudo Ikpeazu A1 Emmanuel Kelechi Nwala YR 2022 UL http://www.ghspjournal.org/content/10/2/e2100550.abstract AB Key FindingsMost people living with HIV (PLHIV) receiving free HIV treatment services are willing to pay for the services if such free treatment services are no longer available.The socioeconomic status of PLHIV plays a critical role in the willingness to pay for treatment. The willingness is further enhanced by the availability of financial support from friends and family.The maximum price that most patients are willing to pay for HIV treatment services is less than the current cost of providing services and the different price points are elastic relative to the estimated current price of providing services.Key ImplicationsThe domestic funding for HIV treatment services in low-income countries can be improved through cost recovery from patient contribution to the cost of treatment.Equitable access to HIV treatment services can be achieved by ensuring that patients are segmented based on socioeconomic status to identify those that can benefit from free services, subsidized and full-priced payment for treatment services.Willingness to pay for HIV treatment services and funding sustainability of the HIV treatment program can be enhanced by reducing the cost of treatment, which improves treatment affordability.Background:About 50% of individuals needing HIV treatment are unable to access required services primarily due to the inability of the Nigerian HIV treatment program to meet patient needs. We explored patient willingness to pay for HIV treatment, which can inform the feasibility of cost recovery through patient fees to contribute to the funding of HIV treatment services in Nigeria.Methods:We conducted a cross-sectional survey of 400 people living with HIV randomly selected from 15 health care facilities providing free HIV treatment services in 2 medium and high HIV burden states (Lagos, Enugu) and the Federal Capital Territory Abuja. We calculated the elasticity of the price that patients were willing to pay per month relative to the estimated current cost of providing HIV treatment services per patient and determined the patient coverage and potential cost recovery at each price point.Results:We found that 92% of patients were willing to pay for HIV treatment. The mean amount patients were willing to pay was 3,000 naira (US$7.50) per month with about 18% of patients willing to pay the current monthly price of 5000 naira (US$12.50). The availability of financial support from family and friends (odds ratio [OR]=14.209; P=.001; 95% confidence interval [CI]=0.151, 0.285), lack of employment (OR=0.190; P=.02; 95% CI=0.015, 0.202), monthly income (OR=2.476; P<.001; 95% CI=84.698, 737.233), and change in monthly income (OR=2.015; P<.001; 95% CI=0.003, 0.229) were associated with willingness to pay.Conclusion:Many Nigerian patients are willing to contribute to funding for HIV treatment and this can enhance domestic funding for HIV treatment and equitable access to treatment through proper segmentation of patients based on willingness and capacity to pay. Measures must be put in place to reduce the cost of accessing HIV treatment and promote financial empowerment of people living with HIV to improve willingness to pay for treatment.