Using choice experiments to improve equity in access to socially marketed HIV prevention products
Using choice experiments to improve equity in access to socially marketed HIV prevention products
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DOI：
10.1016/j.jocm.2021.100319
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发表时间：
2021-09-04
影响因子：
2.4
通讯作者：
Hanson, Kara
中科院分区：
文献类型：
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作者：
Terris-Prestholt, Fern;Mulatu, Abay;Hanson, Kara
制定战略以引进新的艾滋病毒预防技术，需要在公平获取与可持续分配之间取得平衡，特别是在艾滋病毒流行率高、资源有限的情况下。本文探讨了偏好异质性的知识如何通过差异化广告和产品植入来指导艾滋病毒预防产品的公平定向，以平衡增加的可获得性和可持续性。一项离散选择试验引发了1016名妇女对在南非分销艾滋病毒预防产品的偏好。定性研究指导了实验设计，考虑了分销渠道、收集方式、广告信息和价格。比较了随机参数Logit模型、潜在类随机参数Logit模型和潜在类随机参数Logit模型等多种选择模型的适用性。潜在的阶级模型显示了最适合和区分两类妇女：第一类妇女明显更有可能同居和失业，她们更喜欢通过诊所分销的艾滋病毒预防广告产品，并且对价格高度敏感。第二类明显倾向于通过药房和围绕赋予妇女权力的广告进行分销，而价格并不是一个关键因素。这一分析表明，可以通过利用群体之间的偏好异质性来促进获得新产品的公平。然后，识别出的群体可用于设计社会营销差异化分配策略。免费分发用于预防艾滋病毒的产品可以防止向有一定支付能力的妇女“泄露”得到高补贴的产品，而通过药房销售的为赋予妇女权力而定价的产品可以鼓励收回成本，同时最大限度地减少就业妇女的覆盖面。
Designing strategies to introduce new HIV prevention technologies requires balancing equitable access with sustainable distribution, particularly in resource constrained settings with high HIV prevalence. This paper explores how knowledge of preference heterogeneity can guide the equitable targeting of HIV prevention products using differentiated advertising and product placement to balance increased access with sustainability. A discrete choice experiment elicited 1016 women's preferences for distribution of HIV prevention products in South Africa. Qualitative research guided the experimental design which considered distribution outlet, collection method, advertising message, and price. A range of choice models, including random parameters logit, latent class and latent class random parameters logit models, were compared for fit. A latent class model showed the best fit and distinguished two classes of women: Class 1 were significantly more likely to be cohabiting and unemployed, who preferred products advertised for HIV prevention distributed through clinics and were highly price sensitive. Class 2 significantly preferred distribution through pharmacies and advertising around women's empowerment, while price was not a key factor. This analysis suggests that equity in access to new products could be advanced through exploiting preference heterogeneity between groups. The identified groups can be then used to design social marketing differentiated distribution strategies. Distributing free products promoted for HIV prevention could discourage 'leakage' of highly subsidised products to women with some capacity to pay, while priced products marketed for women's empowerment through pharmacies could encourage cost recovery with minimal reductions in coverage among employed women.