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The purpose of this study is to estimate the average cost of treatment and investigate the related parameters of HIV/AIDS among patients based on their annual treatment regime during the 2017 in Izmir.

The average annual direct cost of an HIV patient's treatment was estimated for 2017 at four university hospitals in a retrospective study in Izmir, Turkey. Inclusion criteria included confirmed HIV infection, age = 18 years, visited one of the hospitals at least three times a year and with at least one CD4+ T cell count. The average annual treatment cost per patient was calculated using accounting data for 527 patients from the hospitals' electronic databases.

The mean treatment cost per patient was US$4,381.93. Costs for treatment and care were statistically significantly higher (US$5,970.55) for patients with CD4+ T cell counts of fewer than 200 cells/mm³ than for other patients with CD4+ T cell counts above 200 cells/mm³. The mean treatment cost for patients who were 50 years old or older (US$4,904.24) was statistically significantly higher than for those younger than 50 years (US$4,216.10). The mean treatment cost for female patients (US$4,624.92) was higher than that of male patients ($US4,339.72), although the difference was not statistically significant. The main cost driver was antiretroviral treatment (US$3,852.38 per patient), accounting for almost 88% of all costs. However, the high burden of antiretroviral treatment cost is counterbalanced by relatively low care and hospitalization costs in Turkey.

The paper contributes to the literature by providing average annual treatment cost of an HIV-infected patient in Turkey by using a comprehensive bottom up approach. Moreover, cost drivers of HIV treatment are investigated.

The main purpose of this study is to create a reliable and valid scale to assess the destination food image perceived by the tourists regarding the food in Turkey within the cognitive and affective image component framework. In line with this purpose, both scale development and scale adaptation studies are conducted, and measurement invariance of the scale for gender is analyzed.

This study uses the survey model among quantitative research methods. Scale development processes are used to assess the cognitive image; the construct validity is analyzed with exploratory factor analysis (n = 328), confirmatory factor analysis (n = 425) and convergent and discriminant validity. Scale adaptation processes are followed to assess the affective image, and construct validity is tested with confirmatory factor analysis (n = 425). The reliability of both scales is investigated with Cronbach's alpha. Cochran–Mantel–Haenszel (CMH) analysis is conducted for measurement invariance for gender.

Construct validity and reliability provided the desired values in all processes. Measurement invariance results proved that the scale does not change according to genders.

The data obtained in this study have geographical limitations, and the data represent tourists visiting Antalya, an important tourism destination in Turkey.

The scale will provide concrete information about the destination food image and help practitioners to test the model and develop future strategies for the destination.

This study presents an integrated approach to understanding the destination food image and expands theoretical and empirical evidence by creating a scale that measures both cognitive and affective image component. Scale-invariant shows that there is no item bias for analyzed gender and contributes to generalizability.