Willingness-to-pay for home delivery of antiretrovirals: A cross-sectional contingent valuation study in Southern Nigeria

Abstract

Home delivery enhances access to antiretrovirals through differentiated care. This study aimed to assess the willingness-to-pay for home delivery of antiretrovirals by people living with HIV in the southern part of Nigeria using a contingent valuation method. The study is a cross-sectional study and it was conducted in the HIV centers in three federal teaching hospitals located in three regions of the geopolitical zones in the southern part of Nigeria. The study was carried out from April 2022 to March 2023. A total of 945 self-administered questionnaires were distributed to HIV clients, and the willingness to pay was investigated using a contingent valuation technique. The predictors for the willingness-to-pay were explored using multiple logistic regressions. Majority (70%) of the respondents were not willing to pay for the delivery of their antiretrovirals to their homes. Out of those willing to pay, only one-third of them were willing to pay a monthly stipend of $1.3 ± 0.4 for the drug delivery. Furthermore, this study found that respondents employed in the private sector are more willing to pay for the delivery of antiretrovirals to their homes, with an odds ratio of 3.2, a 95% confidence interval of (1.43-7.00), and a p-value of 0.004.The study found that most persons living with HIV in the southern part of Nigeria are unwilling to pay for home delivery of their antiretrovirals, despite receiving free antiretrovirals from healthcare facilities.