Heterogeneity in individual preferences for HIV testing: A systematic literature review of discrete choice experiments
Background: Understanding variations in HIV testing preferences can help inform optimal combinations of testing services to maximize coverage. We conducted a systematic review of Discrete Choice Experiments (DCEs) eliciting HIV testing preference. Methods: We searched the published literature for pa...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | EClinicalMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537020303977 |
| _version_ | 1819052706063450112 |
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| author | Monisha Sharma Jason J. Ong Connie Celum Fern Terris-Prestholt |
| author_facet | Monisha Sharma Jason J. Ong Connie Celum Fern Terris-Prestholt |
| author_sort | Monisha Sharma |
| collection | DOAJ |
| description | Background: Understanding variations in HIV testing preferences can help inform optimal combinations of testing services to maximize coverage. We conducted a systematic review of Discrete Choice Experiments (DCEs) eliciting HIV testing preference. Methods: We searched the published literature for papers that conducted DCEs to assess user preferences for HIV testing. Findings: We identified 237 publications; 14 studies conducted in 10 countries met inclusion criteria. Overall, test cost was one of the strongest drivers of preference, with participants preferring free or very low-cost testing. Confidentiality was a salient concern, particularly among key populations and persons who never tested. Participants in resource-limited settings preferred short travel distance and integration of HIV testing with other services. There was substantial heterogeneity across participant characteristics. For example, while women preferred home testing, high-risk groups (e.g. male porters, female bar workers) and men who had not tested in the last year preferred traveling a short distance for testing. HIV self-testing (HIVST) had high acceptability, particularly among those who had never HIV tested, although most users preferred blood-based sample collection over oral swabs. Participants highly valued post-test counselling availability after HIVST. Interpretation: Overall, participants value low-cost, confidential testing with short travel distance. HIVST is a promising strategy to increase testing coverage but post-test counseling and support should be made available. Educational campaigns to increase familiarity and build confidence in results of oral testing can improve the success of HIVST. DCEs conducted within clinic settings likely have limited generalizability to those not seeking care, particularly for key populations. |
| first_indexed | 2024-12-21T12:24:05Z |
| format | Article |
| id | doaj.art-ff70f82cef7e498ba3d7151576f0f4de |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-21T12:24:05Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-ff70f82cef7e498ba3d7151576f0f4de2022-12-21T19:04:14ZengElsevierEClinicalMedicine2589-53702020-12-0129100653Heterogeneity in individual preferences for HIV testing: A systematic literature review of discrete choice experimentsMonisha Sharma0Jason J. Ong1Connie Celum2Fern Terris-Prestholt3Department of Global Health, University of Washington, School of Public Health, 908 Jefferson St, Seattle, WA 98104, United States; Corresponding author.Department of Clinical Research and Development, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Central Clinical School, Monash University, Melbourne, AustraliaDepartment of Global Health, University of Washington, School of Public Health, 908 Jefferson St, Seattle, WA 98104, United States; Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, United StatesDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United KingdomBackground: Understanding variations in HIV testing preferences can help inform optimal combinations of testing services to maximize coverage. We conducted a systematic review of Discrete Choice Experiments (DCEs) eliciting HIV testing preference. Methods: We searched the published literature for papers that conducted DCEs to assess user preferences for HIV testing. Findings: We identified 237 publications; 14 studies conducted in 10 countries met inclusion criteria. Overall, test cost was one of the strongest drivers of preference, with participants preferring free or very low-cost testing. Confidentiality was a salient concern, particularly among key populations and persons who never tested. Participants in resource-limited settings preferred short travel distance and integration of HIV testing with other services. There was substantial heterogeneity across participant characteristics. For example, while women preferred home testing, high-risk groups (e.g. male porters, female bar workers) and men who had not tested in the last year preferred traveling a short distance for testing. HIV self-testing (HIVST) had high acceptability, particularly among those who had never HIV tested, although most users preferred blood-based sample collection over oral swabs. Participants highly valued post-test counselling availability after HIVST. Interpretation: Overall, participants value low-cost, confidential testing with short travel distance. HIVST is a promising strategy to increase testing coverage but post-test counseling and support should be made available. Educational campaigns to increase familiarity and build confidence in results of oral testing can improve the success of HIVST. DCEs conducted within clinic settings likely have limited generalizability to those not seeking care, particularly for key populations.http://www.sciencedirect.com/science/article/pii/S2589537020303977PreferencesHIV testingDiscrete choice experimentSystematic reviewHIVSub-Saharan Africa |
| spellingShingle | Monisha Sharma Jason J. Ong Connie Celum Fern Terris-Prestholt Heterogeneity in individual preferences for HIV testing: A systematic literature review of discrete choice experiments EClinicalMedicine Preferences HIV testing Discrete choice experiment Systematic review HIV Sub-Saharan Africa |
| title | Heterogeneity in individual preferences for HIV testing: A systematic literature review of discrete choice experiments |
| title_full | Heterogeneity in individual preferences for HIV testing: A systematic literature review of discrete choice experiments |
| title_fullStr | Heterogeneity in individual preferences for HIV testing: A systematic literature review of discrete choice experiments |
| title_full_unstemmed | Heterogeneity in individual preferences for HIV testing: A systematic literature review of discrete choice experiments |
| title_short | Heterogeneity in individual preferences for HIV testing: A systematic literature review of discrete choice experiments |
| title_sort | heterogeneity in individual preferences for hiv testing a systematic literature review of discrete choice experiments |
| topic | Preferences HIV testing Discrete choice experiment Systematic review HIV Sub-Saharan Africa |
| url | http://www.sciencedirect.com/science/article/pii/S2589537020303977 |
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