A discrete choice experiment investigating HIV testing preferences in South Africa

P Chiwire; A C Mühlbacher; S M Evers; H Mahomed; J Ostermann; M Hiligsmann

doi:10.1080/13696998.2022.2055937

A discrete choice experiment investigating HIV testing preferences in South Africa

P Chiwire^*, A C Mühlbacher, S M Evers, H Mahomed, J Ostermann, M Hiligsmann

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: South Africa (SA) has the world's highest burden of HIV infection, with an estimated 13.7% of the population living with HIV (PLWH/Persons Living With HIV). The early identification of PLWH and rapid engagement of them in HIV treatment are indispensable tools in the fight against HIV transmission. Understanding client preferences for HIV testing may help improve uptake. This study aimed to elicit client preferences for key characteristics of HIV testing options.

METHODS: A discrete-choice experiment (DCE) was conducted among individuals presenting for HIV testing at two public primary healthcare facilities in Cape Town, South Africa. Participants were asked to make nine choices between two unlabeled alternatives that differed in five attributes, in line with previous DCEs conducted in Tanzania and Colombia: testing availability, distance from the testing center, method for obtaining the sample, medication availability at testing centers, and confidentiality. Data were analyzed using a random parameter logit model.

RESULTS: A total of 206 participants agreed to participate in the study, of whom 199 fully completed the choice tasks. The mean age of the participants was 33.6 years, and most participants were female (83%). Confidentiality was the most important attribute, followed by distance from the testing center and the method of obtaining a sample. Patients preferred finger prick to venipuncture as a method for obtaining the sample. Medication availability at the testing site was also preferred over a referral to an HIV treatment center for a positive HIV test. There were significant variations in preferences among respondents.

CONCLUSION: In addition to accentuating the importance of confidentiality, the method for obtaining the sample and the location of sites for collection of medication should be considered in the testing strategy. The variations in preferences within target populations should be considered in identifying optimal testing strategies.

Original language	English
Pages (from-to)	481-490
Number of pages	10
Journal	Journal of Medical Economics
Volume	25
Issue number	1
DOIs	https://doi.org/10.1080/13696998.2022.2055937
Publication status	Published - 23 Mar 2022

Keywords

Adult
Choice Behavior
Female
HIV Infections/diagnosis
HIV Testing
Humans
Patient Preference
South Africa
SEX
AIDs
ACCEPTABILITY
preferences for HIV testing
COUPLES
EXPERIENCES
MEN
HIV testing
stated preferences
people living with HIV
Discrete choice experiment

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10.1080/13696998.2022.2055937Licence: CC BY-NC-ND

Cite this

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title = "A discrete choice experiment investigating HIV testing preferences in South Africa",

abstract = "BACKGROUND: South Africa (SA) has the world's highest burden of HIV infection, with an estimated 13.7% of the population living with HIV (PLWH/Persons Living With HIV). The early identification of PLWH and rapid engagement of them in HIV treatment are indispensable tools in the fight against HIV transmission. Understanding client preferences for HIV testing may help improve uptake. This study aimed to elicit client preferences for key characteristics of HIV testing options.METHODS: A discrete-choice experiment (DCE) was conducted among individuals presenting for HIV testing at two public primary healthcare facilities in Cape Town, South Africa. Participants were asked to make nine choices between two unlabeled alternatives that differed in five attributes, in line with previous DCEs conducted in Tanzania and Colombia: testing availability, distance from the testing center, method for obtaining the sample, medication availability at testing centers, and confidentiality. Data were analyzed using a random parameter logit model.RESULTS: A total of 206 participants agreed to participate in the study, of whom 199 fully completed the choice tasks. The mean age of the participants was 33.6 years, and most participants were female (83%). Confidentiality was the most important attribute, followed by distance from the testing center and the method of obtaining a sample. Patients preferred finger prick to venipuncture as a method for obtaining the sample. Medication availability at the testing site was also preferred over a referral to an HIV treatment center for a positive HIV test. There were significant variations in preferences among respondents.CONCLUSION: In addition to accentuating the importance of confidentiality, the method for obtaining the sample and the location of sites for collection of medication should be considered in the testing strategy. The variations in preferences within target populations should be considered in identifying optimal testing strategies.",

keywords = "Adult, Choice Behavior, Female, HIV Infections/diagnosis, HIV Testing, Humans, Patient Preference, South Africa, SEX, AIDs, ACCEPTABILITY, preferences for HIV testing, COUPLES, EXPERIENCES, MEN, HIV testing, stated preferences, people living with HIV, Discrete choice experiment",

author = "P Chiwire and M{\"u}hlbacher, {A C} and Evers, {S M} and H Mahomed and J Ostermann and M Hiligsmann",

note = "Funding Information: The authors would like to thank the Western Cape Government: Health for allowing us access to the facilities. Second, the facility managers at the two sites made data collection easy. We want to acknowledge Ms. Ife Alaba for assisting with data collection. Publisher Copyright: {\textcopyright} 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.",

year = "2022",

month = mar,

day = "23",

doi = "10.1080/13696998.2022.2055937",

language = "English",

volume = "25",

pages = "481--490",

journal = "Journal of Medical Economics",

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T1 - A discrete choice experiment investigating HIV testing preferences in South Africa

AU - Chiwire, P

AU - Mühlbacher, A C

AU - Evers, S M

AU - Mahomed, H

AU - Ostermann, J

AU - Hiligsmann, M

N1 - Funding Information: The authors would like to thank the Western Cape Government: Health for allowing us access to the facilities. Second, the facility managers at the two sites made data collection easy. We want to acknowledge Ms. Ife Alaba for assisting with data collection. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2022/3/23

Y1 - 2022/3/23

N2 - BACKGROUND: South Africa (SA) has the world's highest burden of HIV infection, with an estimated 13.7% of the population living with HIV (PLWH/Persons Living With HIV). The early identification of PLWH and rapid engagement of them in HIV treatment are indispensable tools in the fight against HIV transmission. Understanding client preferences for HIV testing may help improve uptake. This study aimed to elicit client preferences for key characteristics of HIV testing options.METHODS: A discrete-choice experiment (DCE) was conducted among individuals presenting for HIV testing at two public primary healthcare facilities in Cape Town, South Africa. Participants were asked to make nine choices between two unlabeled alternatives that differed in five attributes, in line with previous DCEs conducted in Tanzania and Colombia: testing availability, distance from the testing center, method for obtaining the sample, medication availability at testing centers, and confidentiality. Data were analyzed using a random parameter logit model.RESULTS: A total of 206 participants agreed to participate in the study, of whom 199 fully completed the choice tasks. The mean age of the participants was 33.6 years, and most participants were female (83%). Confidentiality was the most important attribute, followed by distance from the testing center and the method of obtaining a sample. Patients preferred finger prick to venipuncture as a method for obtaining the sample. Medication availability at the testing site was also preferred over a referral to an HIV treatment center for a positive HIV test. There were significant variations in preferences among respondents.CONCLUSION: In addition to accentuating the importance of confidentiality, the method for obtaining the sample and the location of sites for collection of medication should be considered in the testing strategy. The variations in preferences within target populations should be considered in identifying optimal testing strategies.

AB - BACKGROUND: South Africa (SA) has the world's highest burden of HIV infection, with an estimated 13.7% of the population living with HIV (PLWH/Persons Living With HIV). The early identification of PLWH and rapid engagement of them in HIV treatment are indispensable tools in the fight against HIV transmission. Understanding client preferences for HIV testing may help improve uptake. This study aimed to elicit client preferences for key characteristics of HIV testing options.METHODS: A discrete-choice experiment (DCE) was conducted among individuals presenting for HIV testing at two public primary healthcare facilities in Cape Town, South Africa. Participants were asked to make nine choices between two unlabeled alternatives that differed in five attributes, in line with previous DCEs conducted in Tanzania and Colombia: testing availability, distance from the testing center, method for obtaining the sample, medication availability at testing centers, and confidentiality. Data were analyzed using a random parameter logit model.RESULTS: A total of 206 participants agreed to participate in the study, of whom 199 fully completed the choice tasks. The mean age of the participants was 33.6 years, and most participants were female (83%). Confidentiality was the most important attribute, followed by distance from the testing center and the method of obtaining a sample. Patients preferred finger prick to venipuncture as a method for obtaining the sample. Medication availability at the testing site was also preferred over a referral to an HIV treatment center for a positive HIV test. There were significant variations in preferences among respondents.CONCLUSION: In addition to accentuating the importance of confidentiality, the method for obtaining the sample and the location of sites for collection of medication should be considered in the testing strategy. The variations in preferences within target populations should be considered in identifying optimal testing strategies.

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KW - Choice Behavior

KW - Female

KW - HIV Infections/diagnosis

KW - HIV Testing

KW - Humans

KW - Patient Preference

KW - South Africa

KW - SEX

KW - AIDs

KW - ACCEPTABILITY

KW - preferences for HIV testing

KW - COUPLES

KW - EXPERIENCES

KW - MEN

KW - HIV testing

KW - stated preferences

KW - people living with HIV

KW - Discrete choice experiment

U2 - 10.1080/13696998.2022.2055937

DO - 10.1080/13696998.2022.2055937

M3 - Article

C2 - 35315750

SN - 1369-6998

VL - 25

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JO - Journal of Medical Economics

JF - Journal of Medical Economics

IS - 1

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