Resume

• 2003

  MPH

  QUANTITATIVE METHODS

• 1992

  PhD

  Economics

• 1989

  MSc

  Environmental and Natural Resources Economics and Planning

  State University of New York College of Environmental Sciences and Forestry

• 1981

  Haitian Creole

  French

  BS

  Agronomie

  Faculte d'Agronomie et de Medecine Veterinaire

• SPSS

  Stata

  Literature Reviews

  Data Analysis

  Grant Writing

  SAS

  Public Health

  Research Design

  Program Evaluation

  Psychology

  Epidemiology

  Qualitative Research

  Statistics

  Global Health

  Health Economics

  Biostatistics

  The Financial Burden of Morbidity in HIV-Infected Adults on Antiretroviral Therapy in Côte d'Ivoire

  Abstract\nBackground\nLarge HIV care programs frequently subsidize antiretroviral (ARV) drugs and CD4 tests

  but patients must often pay for other health-related drugs and services. We estimated the financial burden of health care for households with HIV-infected adults taking antiretroviral therapy (ART) in Côte d'Ivoire.\n\n\nMethodology/Principal Findings\nWe conducted a cross-sectional survey. After obtaining informed consent

  we interviewed HIV-infected adults taking ART who had consecutively attended one of 18 HIV care facilities in Abidjan. We collected information on socioeconomic and medical characteristics. The main economic indicators were household capacity-to-pay (overall expenses minus food expenses)

  and health care expenditures. The primary outcome was the percentage of households confronted with catastrophic health expenditures (health expenditures were defined as catastrophic if they were greater than or equal to 40% of the capacity-to-pay). We recruited 1

  190 adults. Median CD4 count was 187/mm3

  median time on ART was 14 months

  and 72% of subjects were women. Mean household capacity-to-pay was $213.7/month

  mean health expenditures were $24.3/month

  and 12.3% of households faced catastrophic health expenditures. Of the health expenditures

  75.3% were for the study subject (ARV drugs and CD4 tests

  24.6%; morbidity events diagnosis and treatment

  50.1%; transportation to HIV care centres

  25.3%) and 24.7% were for other household members. When we stratified by most recent CD4 count

  morbidity events related expenses were significantly lower when subjects had higher CD4 counts.\n\n\nConclusions/Significance\nMany households in Côte d'Ivoire face catastrophic health expenditures that are not attributable to ARV drugs or routine follow-up tests. Innovative schemes should be developed to help HIV-infected patients on ART face the cost of morbidity events.

  The Financial Burden of Morbidity in HIV-Infected Adults on Antiretroviral Therapy in Côte d'Ivoire

  Alexandre

  Alexandre

  Johns Hopkins University

  Florida Atlantic University

  Johns Hopkins Bloomberg School of Public Health

  University of Miami

  University of Miami

  Florida Atlantic University

  Health Administration Programs - Management Department/College of Business

  Associate Professor and Director

  Johns Hopkins Bloomberg School of Public Health

  Assistant Professor of Health Economics

  Johns Hopkins University