HIV testing preferences among pregnant women attending antenatal care and their male partners: a discrete choice experiment in Uganda

Korte, Jeffrey E.; Strauss, Michael; Bâ, Aïssatou; Buregyeya, Esther; Matovu, Joseph K. B.; Kisa, Rose; Musoke, William; Chemusto, Harriet; Vrana-Diaz, Caroline; Malek, Angela M.; Wanyenze, Rhoda K.; George, Gavin

doi:10.2989/16085906.2019.1686032

Cited by 16 publications

(17 citation statements)

References 39 publications

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“…Fifteen studies investigated combinations of voluntary testing and counseling product and service design [ 24 , 28 , 44 , 45 , 50 , 53 – 55 , 86 , 88 , 93 , 95 , 96 , 99 , 102 ].…”

Section: Resultsmentioning

confidence: 99%

“…The most common attribute was cost (US$0–4 in lower income settings, US$ ≤ 30 in high-income settings); generally, participants preferred free testing [ 28 , 50 , 54 , 55 ]. Other common attributes involved logistical issues: location (home, clinic) and distance to services [ 28 , 44 , 50 , 55 ]; evening or weekend hours [ 44 ]; length of the visit [ 28 ]; and time to get results [ 50 , 54 , 55 ]. Testing at home and immediate access to results were preferred.…”

Section: Resultsmentioning

confidence: 99%

“…Multiple studies compared men and women, seeking strategies to increase men’s access to HIV testing. These findings suggest more men may be reached with home-based, counselor-administered (vs nurse or self), immediate, and same-site access to antiretroviral therapy, bundling with other medical screenings (diabetes mellitus, tuberculosis), and providing monetary incentives [ 28 , 45 , 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of the 28 studies that employed DCE, several base statistical models were reported, including conditional logit (4, 14%) [27][28][29][30], multinomial logit (5, 18%) [31][32][33][34][35][36], ordinary least-squares regression (2, 7%) [37,38], and logistic regression (1) [39]. Three (11%) reported relative impor-tance scores [32,40,41].…”

Section: Dcementioning

confidence: 99%

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Eliciting Preferences for HIV Prevention Technologies: A Systematic Review

Beckham

Crossnohere

Gross

et al. 2020

Patient

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Background Many human immunodeficiency virus (HIV) prevention technologies (pre-exposure prophylaxis, microbicides, vaccines) are available or in development. Preference elicitation methods provide insight into client preferences that may be used to optimize products and services. Given increased utilization of such methods in HIV prevention, this article identifies and reviews these methods and synthesizes their application to HIV prevention technologies. Methods In May 2020, we systematically searched peer-reviewed literature in PubMed, CINAHL, and Web of Science for studies employing quantitative preference elicitation methods to measure preferences for HIV prevention technologies among populations of any age, sex, or location. Quality assessment used an existing checklist (PREFS) and a novel adaptation of the Newcastle–Ottawa Scale (PROSPERO #CRD42018087027). Results We screened 5022 titles and abstracts, reviewed 318 full texts, and included 84 studies. Common methods employed were discrete-choice experiment (33%), conjoint analysis (25%), and willingness-to-participate/try/accept (21%). Studies were conducted in 25 countries and had a mean of 768 participants (range = 26–7176), two-thirds of them male. Common HIV prevention technologies included pre-exposure prophylaxis (23%), voluntary testing and counseling (19%), HIV self-testing (17%), vaccines (15%), and topical microbicides (9%). Most attributes focused on product design (side effects, frequency), service design (provider type, location), acceptability or willingness to accept/pay; results are summarized in these categories, by prevention type. Mean quality-adapted Newcastle–Ottawa Scale score was 4.5/8 (standard deviation = 2.1) and mean PREFS scores was 3.47/5 (standard deviation = 0.81). Conclusions This review synthesizes extant literature on quantitative measurement of preferences for HIV prevention technologies. This can enable practitioners to improve prevention products and interventions, and ultimately reduce HIV incidence.

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“…Fifteen studies investigated combinations of voluntary testing and counseling product and service design [ 24 , 28 , 44 , 45 , 50 , 53 – 55 , 86 , 88 , 93 , 95 , 96 , 99 , 102 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Dcementioning

confidence: 99%

See 2 more Smart Citations

Eliciting Preferences for HIV Prevention Technologies: A Systematic Review

Beckham

Crossnohere

Gross

et al. 2020

Patient

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show abstract

“…Two participants mentioned they discussed testing when their wives were pregnant, which most is likely due to routine testing in antenatal care. In a recent study analysing HIV self-testing preferences among pregnant women and male partners in Uganda, all participants preferred to have a nurse administer the test rather than to self-test (Korte et al, 2019). However, they both preferred the oral over finger prick test and to test with their partners.…”

Section: Discussionmentioning

confidence: 99%

Applying a social-ecological lens to opinions about HIV self-testing among Kenyan truckers who declined to test: a qualitative study

Christian

Mantell

Romo

et al. 2020

African Journal of AIDS Research

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HIV prevalence among truckers in Africa is high and testing rates suboptimal. With numerous African countries having approved HIV self-testing kits, more information on how to design acceptable and accessible self-testing programs for high-risk populations is necessary. We explored views about self-testing via in-depth interviews with 24 truckers participating in a randomised controlled trial who refused HIV testing. A social-ecological lens was used to guide data analysis and frame study findings. While most participants said that they would use an HIV self-test, perceived barriers and facilitators were identified at multiple levels. Many participants noted lack of time to test or obtain a self-test kit as a major barrier (intrapersonal) and varied in their views about self-testing with a partner (interpersonal). Participants offered programmatic/policy recommendations, suggesting that they preferred accessing self-test kits in settings where training could be provided. Participants believed they should be able to pick up multiple test kits at the same time and that the test kits should be free or low cost. These study findings will help guide the design of self-testing programs for truckers and other mobile populations.

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A community‐based dynamic choice model for HIV prevention improves PrEP and PEP coverage in rural Uganda and Kenya: a cluster randomized trial

Kakande,

Ayieko,

Sunday

et al. 2023

J Int AIDS Soc.

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IntroductionOptimizing HIV prevention may require structured approaches for providing client‐centred choices as well as community‐based entry points and delivery. We evaluated the effect of a dynamic choice model for HIV prevention, delivered by community health workers (CHWs) with clinician support, on the use of biomedical prevention among persons at risk of HIV in rural East Africa.MethodsWe conducted a cluster randomized trial among persons (≥15 years) with current or anticipated HIV risk in 16 villages in Uganda and Kenya (SEARCH; NCT04810650). The intervention was a client‐centred HIV prevention model, including (1) structured client choice of product (pre‐exposure prophylaxis [PrEP] or post‐exposure prophylaxis [PEP]), service location (clinic or out‐of‐clinic) and HIV testing modality (self‐test or rapid test), with the ability to switch over time; (2) a structured assessment of patient barriers and development of a personalized support plan; and (3) phone access to a clinician 24/7. The intervention was delivered by CHWs and supported by clinicians who oversaw PrEP and PEP initiation and monitoring. Participants in control villages were referred to local health facilities for HIV prevention services, delivered by Ministry of Health staff. The primary outcome was biomedical prevention coverage: a proportion of 48‐week follow‐up with self‐reported PrEP or PEP use.ResultsFrom May to July 2021, we enrolled 429 people (212 intervention; 217 control): 57% women and 35% aged 15–24 years. Among intervention participants, 58% chose PrEP and 58% chose PEP at least once over follow‐up; self‐testing increased from 52% (baseline) to 71% (week 48); ≥98% chose out‐of‐facility service delivery. Among 413 (96%) participants with the primary outcome ascertained, average biomedical prevention coverage was 28.0% in the intervention versus 0.5% in the control: a difference of 27.5% (95% CI: 23.0–31.9%, p<0.001). Impact was larger during periods of self‐reported HIV risk: 36.6% coverage in intervention versus 0.9% in control, a difference of 35.7% (95% CI: 27.5–43.9, p<0.001). Intervention effects were seen across subgroups defined by sex, age group and alcohol use.ConclusionsA client‐centred dynamic choice HIV prevention intervention, including the option to switch between products and CHW‐based delivery in the community, increased biomedical prevention coverage by 27.5%. However, substantial person‐time at risk of HIV remained uncovered.

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HIV testing preferences among pregnant women attending antenatal care and their male partners: a discrete choice experiment in Uganda

Abstract: View related articles View Crossmark data Citing articles: 2 View citing articles African Journal of AIDS Research is co-published by NISC (Pty) Ltd and Informa UK Limited (trading as Taylor & Francis Group)

Cited by 16 publications

References 39 publications

Eliciting Preferences for HIV Prevention Technologies: A Systematic Review

Eliciting Preferences for HIV Prevention Technologies: A Systematic Review

Applying a social-ecological lens to opinions about HIV self-testing among Kenyan truckers who declined to test: a qualitative study

A community‐based dynamic choice model for HIV prevention improves PrEP and PEP coverage in rural Uganda and Kenya: a cluster randomized trial

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