Willingness to pay for health care and antiretroviral drugs, determinants of HIV testing and of adherence to antiretroviral therapy Evidence from Rural Southern Region of Malawi

This study investigates willingness-to-pay (WTP) for health care services and for antiretroviral (ARV) drugs. It also investigates the determinants of HIV testing and of patients’ adherence to antiretroviral therapy. The study employs contingent valuation method to determine WTP for health care services and ARV drugs. It also draws on health belief and health decision models to identify correlates of HIV testing and of adherence to treatment. The results show that user status of an individual and income of the household increase the odds of WTP for health care services and ARVs. Price of health care and ARVs decrease the odds of WTP. Knowledge of the benefits of HIV/AIDS testing increases the odds of testing. High likelihood of current HIV infection reduces the odds of testing. Social support and improvement in patient health status increase the odds of adherence to treatment Treatment problems increase the odds of nonadherence to ARV treatment. The finding that income increases the odds of WTP implies that an equitable cost- sharing scheme should exempt or subsidise poor households from paying for health care services. The HIV/AIDS prevention and education campaign should provide more information to the general public about the benefits of HIV testing in order to increase the uptake of HIV testing services. Health personnel should find ways of alleviating problems associated with antiretroviral treatment in order to improve patients’ adherence to treatment.