Objective  To examine direct economic burden and its influencing factors of antiretroviral therapy (ART) among human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) patients in Liangshan Yi Autonomous Region (Liangshan) of Sichuan province, and to provide references for improving the medical insurance and assistance and health poverty alleviation policies.

  Methods  Using multistage cluster sampling and a self-designed questionnaire, we conducted a survey among 185 HIV/AIDS patients having ART of more than one year till October 2017 in 5 urban and rural areas of Liangshan during the period from October 2016 to January 2017. Multivariate regression model was adopted to analyze impact factors of the direct economic burden.

  Results  The average direct costs of the disease for the patients in the five areas were 1 422.8, 772.1, 11 402.5, 4 092.8 and 1 675.6 yuan (RMB)/per person year. Compared to those among the Yi patients, rural patients, and the patients with normal living condition, higher direct costs (in yuan) were reported by the Han patients (6 315.9 vs. 1 946.3), urban patients (3 584.4 vs. 2 409.5), and the patients with subsistence allowance (4 024.4 vs. 1 737.8). Main influencing factors for direct economic burden of the patients included place of residence (t = – 2.043, P < 0.05), pain symptom (P < 0.05), and whether continuing to work (P = 0.006).

  Conclusion  The direct economic burden of HIV/AIDS patients with antiretroviral therapy in Liangshan is lower than that of the patients in other part China and the burden differs among the patients in different areas.