What's Available in Costa Rica
There is total access to HIV/AIDS treatment in Costa Rica, according to the national health system, the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social, or CCSS). However, not all antiretroviral medications are available in the country owing to high costs.
HIV Treatment in Costa Rica
The Costa Rican Ministry of Health (Ministerio de Salud de Costa Rica) sets guidelines for HIV prevention and treatment but it does not implement any HIV services. The CCSS is responsible for implementing HIV prevention services and providing treatment to people living with HIV.
Within the health system in Costa Rica, there are 4 national hospitals and 2 regional hospitals that provide ARV treatment. The national hospitals are Hospital Calderón Guardia, Hospital Nacional de Niños, Hospital México, and Hospital San Juan de Dios. The regional hospitals are Hospital Monseñor Sanabria de Puntarenas and Hospital San Rafael de Alajuela.
Antiretroviral therapy is initiated for people with CD4 counts of ˂350 cells as soon as possible after clinical assessment, and they are closely monitored by an interdisciplinary team.
A law enacted in 1998 protects the rights of people living with HIV in Costa Rica.
HIV Diagnosis, Referral, and Follow-Up
Once patients are diagnosed with HIV (at a private clinic that provides HIV testing or at a public hospital), they are referred to the nearest national or regional hospital for treatment. HIV clinics perform CD4 counts and viral load tests, and they start patients on treatment if needed.
Cost of Services
All services are free to Costa Rican nationals and legal residents under the CCSS. People need to find out if they are covered under the system. If they are not, they can pay for their own health insurance under the system, or they can apply for State Social Security (usually, this is for people in extreme poverty). Foreign citizens residing in the country who have health insurance from their country of origin may be eligible for services in a number of the private hospitals in San José. Immigrants with "irregular" immigration status who have resided in the country for at least 1 year can apply for voluntary insurance coverage.
What Patients Will Need
To accelerate the process and avoid out-of-pocket costs for laboratory tests, patients should be encouraged to have the following:
- A 3-month supply of their current HIV medications, if available
- A recent CD4 T-cell count (not always available)
- A recent viral load test result (not always available)
- A copy of their medical chart, including complete antiretroviral treatment history