Women's preferences for HIV prevention service delivery in pharmacies during pregnancy in Western Kenya: a discrete choice experiment

IF 4.6 1区医学 Q2 IMMUNOLOGY Journal of the International AIDS Society Pub Date : 2024-07-05 DOI:10.1002/jia2.26301

Melissa Latigo Mugambi, Ben O. Odhiambo, Annabell Dollah, Mary M. Marwa, Judith Nyakina, John Kinuthia, Jared M. Baeten, Bryan J. Weiner, Grace John-Stewart, Ruanne Vanessa Barnabas, Brett Hauber

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Abstract

Introduction

Pharmacy-delivered HIV prevention services might create more options for pregnant women to use HIV prevention tools earlier and more consistently during pregnancy. We quantified preferences for attributes of potential HIV prevention services among women of childbearing age in Western Kenya.

Methods

From June to November 2023, we administered a face-to-face discrete choice experiment survey to women aged 15–44 in Kenya's Homa Bay, Kisumu and Siaya counties. The survey evaluated preferences for HIV prevention services, described by seven attributes: service location, travel time, type of HIV test, sexually transmitted infection (STI) testing, partner HIV testing, pre-exposure prophylaxis (PrEP) and service fee. Participants answered a series of 12-choice questions. Each question asked them to select one of two service options or no services—an opt-out option. We used hierarchical Bayesian modelling levels to estimate each attribute level's coefficient and understand how attributes influenced service choice.

Results

Overall, 599 participants completed the survey, among whom the median age was 23 years (IQR: 18–27); 33% were married, 20% had a job and worked regularly, and 52% had been pregnant before. Participants, on average, strongly preferred having any HIV prevention service option over none (opt-out preference weight: −5.84 [95% CI: −5.97, −5.72]). The most important attributes were the availability of PrEP (relative importance 27.04% [95% CI: 25.98%, 28.11%]), followed by STI testing (relative importance 20.26% [95% CI: 19.52%, 21.01%]) and partner HIV testing (relative importance: 16.35% [95% CI: 15.79%, 16.90%]). While, on average, participants preferred obtaining services at the clinic more than pharmacies, women prioritized the availability of PrEP, STI testing and partner HIV testing more than the location or cost.

Conclusions

These findings suggest the importance of providing comprehensive HIV prevention services and ensuring PrEP, STI testing and partner HIV testing are available. If pharmacies can offer these services, women are likely to access those services at pharmacies even if they prefer clinics.

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肯尼亚西部妇女在怀孕期间对药店提供艾滋病预防服务的偏好：离散选择实验。

导言：药房提供的艾滋病预防服务可能会为孕妇提供更多选择，让她们在怀孕期间更早、更持续地使用艾滋病预防工具。我们量化了肯尼亚西部育龄妇女对潜在艾滋病预防服务属性的偏好：2023 年 6 月至 11 月，我们对肯尼亚霍马湾、基苏木和西亚县 15-44 岁的女性进行了面对面离散选择实验调查。调查评估了人们对艾滋病预防服务的偏好，这些偏好由七个属性描述：服务地点、旅行时间、艾滋病检测类型、性传播感染 (STI) 检测、伴侣艾滋病检测、暴露前预防 (PrEP) 和服务费用。参与者回答了一系列 12 道选择题。每个问题都要求他们从两个服务选项中选择一个，或者选择不提供服务，即选择退出选项。我们使用分层贝叶斯建模水平来估算每个属性水平的系数，并了解属性如何影响服务选择：共有 599 名参与者完成了调查，其中年龄中位数为 23 岁（IQR：18-27）；33% 已婚，20% 有工作并定期上班，52% 曾经怀孕。平均而言，参与者强烈倾向于选择任何一种艾滋病预防服务，而不是不选择（选择不接受服务的偏好权重：-5.84 [95% CI：-5.97, -5.72]）。最重要的属性是 PrEP 的可用性（相对重要度为 27.04% [95% CI：25.98%，28.11%]），其次是性传播感染检测（相对重要度为 20.26% [95% CI：19.52%，21.01%]）和伴侣 HIV 检测（相对重要度：16.35% [95% CI：15.79%，16.90%]）。平均而言，与药店相比，参与者更倾向于在诊所获得服务，而与地点或费用相比，女性更优先考虑 PrEP、性传播感染检测和伴侣 HIV 检测的可用性：这些研究结果表明，提供全面的艾滋病预防服务并确保提供 PrEP、性传播感染检测和伴侣艾滋病检测非常重要。如果药房能够提供这些服务，即使妇女更愿意去诊所，她们也可能会在药房获得这些服务。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES

CiteScore

8.60

自引率

10.00%

发文量

186

审稿时长

>12 weeks

期刊介绍： The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.