ABSTRACT
<b>Objective</b><br> To investigate the relationship between uses of highly active antiretroviral therapy (HAART) and sexual behavior among people living with HIV (PLHIV) in northeast Thailand.<br><b>Methods</b><br> Data were collected both by interviews using a structured questionnaire and by a self-administered questionnairewith HIV positive patients who made an outpatient visit to a public hospital in northeast Thailand between March2004 and January 2005. Fisher's exact test and multiple logistic regression analysis were conducted to identify thefactors associated with regular condom use when these patients had sex with their spouse/partner.<br><b>Results</b><br> Among 289 patients (146 with HAART and 143 without HAART) who participated in the study, 122 had sex with their spouse/partner in the three months before the survey. Among them, 70 used a condom every time, 17 used a condom sometimes, 32 never, and 3 unknown. Excluding the 6 patients who did not answer all of the questions, 116 patients remained in the analysis. In the multiple logistic regression analysis, sex, education, employment, years since HIV infection, illness episode in the past one month, and use of HAART were entered as the explanatory factors. Use of HAART (odds ratio=9.8, 95% CI: 2.9 - 32.9) and current employment (odds ratio= 5.2, 95%CI: 1.3 - 20.9) were significantly associated with regular condom use.<br><b>Conclusion</b><br> Use of HAART was positively associated with use of condoms when PLHIV had sex with their spouse or partner.
ABSTRACT
The objective of this study is to assess the differences in access to antiretroviral treatment among health insurance recipients, using a patient-based analysis.<br><b>METHODS:</b> The subjects were 324 outpatients with the human immunodeficiency virus who were treated at a regional hospital for infectious diseases in Khon Kaen Province. We collected data every visit of the patients during the study period between April1 and September 30 in 2002. We defined access to antiretroviral treatment as having a prescription for antiretroviral drugs on at least one visit during the study period. We examined the relationship between access to antiretroviral treatment and age, sex, stage of acquired immune deficiency syndrome (AIDS), and health insurance. We also compared the results of the patient-based analysis and the record-based analysis that was used in our previous study.<br><b>RESULTS:</b> Multiple logistic regression analysis shows that patients insured by the Civil Servant Medical Benefit Scheme have better access to antiretroviral treatment than the others (vs. Universal Coverage; odds ratio=11.38, 95% confidence interval=4.09, 31.65). We have also shown that patients with AIDS-related complex have better access to antiretroviral treatment compared to asymptomatic AIDS patients (odds ratio=3.38, 95% confidence interval=1.31-8.76). Values of these odds ratios were lower in the record-based analysis than in the patient-based analysis.<br><b>CONCLUSIONS:</b> Patients insured by the Civil Servant Medical Benefit Scheme had better access to antiretroviral drugs. We reconfirm the differences in access to antiretroviral treatment among health insurance recipients, using the patient-based analysis.
ABSTRACT
The most common method of evaluating beneficial impacts of environmental policies is cost-benefit analysis (CBA). In the present review, CBA methods for air pollution impacts are reviewed. Three types of air pollution effects are identified, including health, productivity, and amenity. Market valuation, stated preference methods, and revealed preference methods are identified for valuing benefits. Three types of costs are described, including private sector costs, societal costs, and governmental regulatory costs. A benefits valuation approach based on Freeman’s principals is described. A costs valuation approach based on U.S. Environmental Protection Agency and Dixon et al. principals is described. Limitations associated with estimates of benefits and costs are summarized. Input assumptions and results are compared for several existing air pollution control analyses. The importance of CBA in environmental policy studies is discussed. Our conceptual approaches should be useful in analyses of urban air pollution impacts and air pollution prevention policies.