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Feasibility and willingness-to-pay for integrated community-based tuberculosis testing.

Publication ,  Journal Article
Goswami, ND; Hecker, E; Holland, DP; Naggie, S; Cox, GM; Mosher, A; Turner, D; Torres, Y; Vickery, C; Ahearn, MA; Blain, MLM; Rasmussen, P; Stout, JE
Published in: Bmc Infect Dis
November 2, 2011

BACKGROUND: Community-based screening for TB, combined with HIV and syphilis testing, faces a number of barriers. One significant barrier is the value that target communities place on such screening. METHODS: Integrated testing for TB, HIV, and syphilis was performed in neighborhoods identified using geographic information systems-based disease mapping. TB testing included skin testing and interferon gamma release assays. Subjects completed a survey describing disease risk factors, healthcare access, healthcare utilization, and willingness to pay for integrated testing. RESULTS: Behavioral and social risk factors among the 113 subjects were prevalent (71% prior incarceration, 27% prior or current crack cocaine use, 35% homelessness), and only 38% had a regular healthcare provider. The initial 24 subjects reported that they would be willing to pay a median $20 (IQR: 0-100) for HIV testing and $10 (IQR: 0-100) for TB testing when the question was asked in an open-ended fashion, but when the question was changed to a multiple-choice format, the next 89 subjects reported that they would pay a median $5 for testing, and 23% reported that they would either not pay anything to get tested or would need to be paid $5 to get tested for TB, HIV, or syphilis. Among persons who received tuberculin skin testing, only 14/78 (18%) participants returned to have their skin tests read. Only 14/109 (13%) persons who underwent HIV testing returned to receive their HIV results. CONCLUSION: The relatively high-risk persons screened in this community outreach study placed low value on testing. Reported willingness to pay for such testing, while low, likely overestimated the true willingness to pay. Successful TB, HIV, and syphilis integrated testing programs in high risk populations will likely require one-visit diagnostic testing and incentives.

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Published In

Bmc Infect Dis

DOI

EISSN

1471-2334

Publication Date

November 2, 2011

Volume

11

Start / End Page

305

Location

England

Related Subject Headings

  • Tuberculosis
  • Tuberculin Test
  • Syphilis
  • Surveys and Questionnaires
  • Patient Acceptance of Health Care
  • Middle Aged
  • Microbiology
  • Male
  • Interferon-gamma Release Tests
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Goswami, N. D., Hecker, E., Holland, D. P., Naggie, S., Cox, G. M., Mosher, A., … Stout, J. E. (2011). Feasibility and willingness-to-pay for integrated community-based tuberculosis testing. Bmc Infect Dis, 11, 305. https://doi.org/10.1186/1471-2334-11-305
Goswami, Neela D., Emily Hecker, David P. Holland, Susanna Naggie, Gary M. Cox, Ann Mosher, Debbie Turner, et al. “Feasibility and willingness-to-pay for integrated community-based tuberculosis testing.Bmc Infect Dis 11 (November 2, 2011): 305. https://doi.org/10.1186/1471-2334-11-305.
Goswami ND, Hecker E, Holland DP, Naggie S, Cox GM, Mosher A, et al. Feasibility and willingness-to-pay for integrated community-based tuberculosis testing. Bmc Infect Dis. 2011 Nov 2;11:305.
Goswami, Neela D., et al. “Feasibility and willingness-to-pay for integrated community-based tuberculosis testing.Bmc Infect Dis, vol. 11, Nov. 2011, p. 305. Pubmed, doi:10.1186/1471-2334-11-305.
Goswami ND, Hecker E, Holland DP, Naggie S, Cox GM, Mosher A, Turner D, Torres Y, Vickery C, Ahearn MA, Blain MLM, Rasmussen P, Stout JE. Feasibility and willingness-to-pay for integrated community-based tuberculosis testing. Bmc Infect Dis. 2011 Nov 2;11:305.
Journal cover image

Published In

Bmc Infect Dis

DOI

EISSN

1471-2334

Publication Date

November 2, 2011

Volume

11

Start / End Page

305

Location

England

Related Subject Headings

  • Tuberculosis
  • Tuberculin Test
  • Syphilis
  • Surveys and Questionnaires
  • Patient Acceptance of Health Care
  • Middle Aged
  • Microbiology
  • Male
  • Interferon-gamma Release Tests
  • Humans