Utilization of HIV-related services from the private health sector: A multi-country analysis

Increasing the participation of the private health sector in the AIDS response could help to achieve universal access to comprehensive HIV prevention, treatment, care and support. Yet little is known about the extent to which the private health sector is delivering HIV-related services. This study uses data from the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) from 12 countries in Africa, Asia and Latin America and the Caribbean to explore use of HIV testing and STI care from the private for-profit sector, and its association with household wealth status.The analysis indicates that the private for-profit health sector is active in HIV-related service delivery, although the level of participation varies by region and country. From 3 to 45 percent of women and 6 to 42 percent of men reported the private for-profit sector as their source of the most recent HIV testing. While in some countries, use of the private for-profit health sector for HIV testing and STI care increases with wealth, in others the relationship is not clear, as there are no significant differences in using private for-profit HIV-related services between the rich and the poor. We conclude that as the global AIDS response evolves from emergency relief to sustained country programs, broader consideration of the role of the private for-profit health sector may be warranted.

Research highlights
► Using multi-country DHS data, this study provides a basis for assessing the utilization of HIV services provided by the private for-profit sector.
► Private for-profit health sector is active in providing HIV services, although the level of participation varies by the country.
► The study revealed that the poor are also using private sectors for HIV services. As the global AIDS response revolves from emergency relief to sustainability, a broader consideration of the role of the private for-profit sector may be warranted.