OBJECTIVES: The scale up of HIV services and access to anti-retroviral therapy in Africa has been made possible in the last 10 years. However, it is important that more sustainable “in country” options are explored for sustainability of services. The adult HIV clinic at the Infectious Diseases Institute (IDI) in Kampala, Uganda has approximately 8000 registered patients who receive care free of charge. We are exploring the possibility that some patients are willing /able to contribute to the cost of their care. Our objective was to explore attitudes and perceptions of patients and staff towards using a fee-based “after hours” clinic (AHC) at IDI.

METHODS:

We employed a cross-sectional, qualitative design. A purposeful sample of 188 adults which included current HIV clients and IDI staff was stratified by gender and age. We conducted 14 focus group discussions and 55 in-depth interviews. Thematic content analysis was conducted and Nvivo Software used to manage data. RESULTS:  There were six key themes that emerged regarding participant perceptions of the AHC.  Access to care (positive and negative), benefits and disadvantages of an AHC, key categories of health care services, recommending the service to friends, sliding scale fee-for-service, and suggestions to improve service delivery. Results suggested that some respondents were willing to pay for consultation, brand-name drugs, lab tests and other services. All were willing to recommend friends/ relatives. Respondents agreed that, as a sign of social responsibility, some money could be used to help underprivileged patients CONCLUSIONS: Our AHC clinic is perceived as beneficial to patients because it provides access to HIV services at convenient times. Many patients are willing to pay for this enhanced service. Promotion of quality private-public partnerships aiming to sustain quality HIV services in Uganda should be encouraged.