The HIV epidemic in heavily affected regions poses a significant burden upon the public health system and resources, in terms of public sector inpatient service provision and national health budget.  In October 2005, access to antiretroviral treatments has been incorporated under the universal health coverage system in Thailand. The increased life expectancy as a result of provision of treatments has subsequently led to increasing prevalence of persons living with HIV/AIDS in need of lifelong treatments, including more costly second and third line regimens.  This has lead to a need for economic evaluations to assess the most cost effective treatment strategies and public health policies to ensure sustainable long term HIV care.

The objectives of the LIWA study are:

1) To assess the socio-demographic impact of ARV treatments on the lives of patients, their family and their community as well as on the health structures

2) To study the cost-effectiveness of access to ARV treatments.

Preliminary Results - 513 patients and 500 controls were interviewed.

A gender-based analysis indicates that women have more and earlier access to HIV testing and ARV treatment than men (Le Coeur S et al. Soc Sci Med, in press).

We also analyzed the intergenerational relationships of HIV-infected patients. Access to ARV plays a major role in shaping their relationship with their parents. Their regained health allows them to work, take care of their family and fulfill their filial duties as expected in the Thai society (Lelièvre E, et al. Res on Aging, under review).

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