title: Care for people living with HIV/AIDS: an assessment of day care centers in northern Thailand.
abstract: A cross-sectional survey of 271 day care center (DCC) members at 9 district hospitals was undertaken using an interviewer-administered questionnaire to assess the psychosocial and economic impact of the services provided by DCCs to people living with HIV/AIDS (PLWHA) and the costs of attending DCCs in Chiang Rai Province in Thailand. Data on the socioeconomic and demographic background of the participants, their reasons for attending DCCs, their medical services usage, the changes DCCs made on their lives, and the cost of attending DCCs were collected. "Receiving information" (37%) and "meeting friends" (32%) were the two most common reasons while fewer participants gave "physical examination" (6%) and "counseling" (0.4%) as their reasons for attending DCCs. Nearly half became more positive about their lives and 40% learned how to live with the disease. Through DCCs, 24% and 58% were receiving prophylaxis for tuberculosis and Pneumocystis carinii pneumonia respectively, and 15% were taking antiretrovirals. The majority (85%) lived with 30 minutes of DCCs, and incurred travel cost up to 30 Baht (1 USD approximately 40 Baht). The mean monthly income of those with jobs was 1,565 Baht and 42% lost wages when attending DCCs, more than half of whom were the main income earners in their families. In conclusion, DCCs benefit PLWHA through their educational and psychological support. However, they can be further utilized for their medical services. As an expansion of antiretroviral treatment is planned in Thailand, the DCCs' role should be fully explored and clearly defined. Minimizing economic and geographical barriers to access are some of the most immediate challenges.
authors.affiliation: World Health Organization Thailand, Bangkok, Thailand.
authors.forename: Keiko
authors.initials: K
authors.lastname: Tsunekawa
authors.forename: Saiyud
authors.initials: S
authors.lastname: Moolphate
authors.forename: Hideki
authors.initials: H
authors.lastname: Yanai
authors.forename: Norio
authors.initials: N
authors.lastname: Yamada
authors.forename: Surin
authors.initials: S
authors.lastname: Summanapan
authors.forename: Jintana
authors.initials: J
authors.lastname: Ngamvithayapong
mesh_terms: D000328:Adult; D001294:Attitude to Health; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003631:Day Care, Medical / Q000191:economics / Q000523:psychology / Q000592:standards*; D004522:Educational Status; D005260:Female; D005382:Financing, Personal / Q000191:economics; D015658:HIV Infections / Q000191:economics / Q000523:psychology* / Q000628:therapy; D006297:Health Services Accessibility / Q000592:standards; D006302:Health Services Research; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D017533:Marital Status; D009042:Motivation; D010353:Patient Education as Topic / Q000592:standards; D011788:Quality of Life; D012944:Social Support; D012959:Socioeconomic Factors; D013785:Thailand; D013997:Time Factors; D014195:Travel