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Allocation of antiretroviral drugs to HIV-infected patients in Togo: perspectives of people living with HIV and healthcare providers
  1. Lonzozou Kpanake1,
  2. Paul Clay Sorum2,
  3. Etienne Mullet3
  1. 1Department of Psychology, University of Québec (TELUQ), Montreal, Québec, Canada
  2. 2Department of Medicine, Albany Medical College, Albany, New York, USA
  3. 3Ethics and Work Laboratory, Institute of Advanced Studies (EPHE), Paris, France
  1. Correspondence to Dr Lonzozou Kpanake, University of Québec (TELUQ), 5800 rue Saint-Denis, bureau 1105, Montréal, Québec, Canada H2S 3L5; lonzozou.kpanake{at}


Aim To explore the way people living with HIV and healthcare providers in Togo judge the priority of HIV-infected patients regarding the allocation of antiretroviral drugs.

Method From June to September 2015, 200 adults living with HIV and 121 healthcare providers living in Togo were recruited for the study. They were presented with stories of a few lines depicting the situation of an HIV-infected patient and were instructed to judge the extent to which the patient should be given priority for antiretroviral drugs. The stories were composed by systematically varying the levels of four factors: (a) the severity of HIV infection, (b) the financial situation of the patient, (c) the patient's family responsibilities and (d) the time elapsed since the first consultation.

Results Five clusters were identified: 65% of the participants expressed the view that patients who are poor and severely sick should be treated as a priority, 13% prioritised treatment of patients who are poor and parents of small children, 12% expressed the view that the poor should be treated as a priority, 4% preferred that the sickest be treated as a priority and 6% wanted all patients to get treatment.

Conclusions WHO's guideline regarding antiretroviral therapy allocation (the sickest first as the sole criterion) currently in use in many African countries does not reflect the preferences of Togolese people living with HIV. For most HIV-infected patients in Togo, patients who cannot get treatment on their own should be treated as a priority.

  • Allocation of Health Care Resources
  • Patient perspective
  • Statistics
  • Demographic Surveys/Attitudes

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  • Contributors LK, PCS and EM designed the study and research material, conducted the statistical analyses and contributed to interpretation of the data. LK supervised the data collection, devised the paper and wrote the first draft. All authors contributed to subsequent drafts and approved the final version of the manuscript.

  • Funding This study was funded by a grant from Canada Research Chairs programme awarded to LK. Grant number: #950-230745.

  • Disclaimer The funding body had no role in the study or the decision to submit the paper for publication.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Institutional Review Board of the University of Québec (TELUQ).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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