Background: We investigated if initiating preventive care against HIV vertical transmission
by antenatal HIV screening is independent of the patients’ source of financial reimbursement
for the care received in sub-Saharan Africa (SSA).
Methods: Using information from the WHO’s Global Health Expenditure Database and the Demographic
Health Surveys Database for 27 sub-Saharan countries, we used Spearman’s correlation
and adjusted survey logistic regression to determine the potential relationship between enrollment
in health insurance and the likelihood that expectant mothers would be offered antenatal HIV
Results: We found that expectant mothers covered by health insurance were more than twice as
likely to be offered antenatal screening for HIV compared to the uninsured. The likelihood differed
by the type of insurance plan the expectant mother carried.
Discussion: Health insurance is more of a financial tool that this study finds to be necessary to
boost the uptake of preventive and therapeutic HIV care in SSA.
Conclusion: The ensuing disparity in receiving proper care could hinder the goals of 90-90-90 and
the forthcoming 95-95-95 plan in SSA.
Keywords: Antenatal screening, health insurance, HIV, HIV screening, Sub-Saharan Africa, Demographic Health Survey
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