Understanding school-going adolescent's preferences for accessing HIV and contraceptive care: findings from a discrete choice experiment among learners in Gauteng, South Africa.
Understanding school-going adolescent's preferences for accessing HIV and contraceptive care: findings from a discrete choice experiment among learners in Gauteng, South Africa.
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DOI：
10.1186/s12913-023-10414-w
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发表时间：
2023-12-08
影响因子：
2.8
通讯作者：
Pascoe, Sophie
中科院分区：
文献类型：
--
作者：
Govathson, Caroline;Long, Lawrence;Moolla, Aneesa;Mngadi-Ncube, Sithabile;Ngcobo, Nkosinathi;Mongwenyana, Constance;Lince-Deroche, Naomi;Pascoe, Sophie
撒哈拉以南非洲的许多青少年无法获得最佳的艾滋病毒和生殖健康服务。为了提高这些服务的利用率，必须了解学习者对如何提供服务的偏好，以便实施战略能够反映这一点。一个离散选择实验（DCE）被用来引起的偏好。DCE于2018年7月至2019年9月期间完成，并在位于豪登（南非）不同社会经济地位（SES）社区的10所高中进行。年龄≥ 15岁（9-12年级）的学习者同意并入组DCE。如果不满18岁，则需要得到父母的同意。条件Logistic回归被用来确定艾滋病毒和避孕服务提供的首选属性。结果按性别和社区SES五分位数分层（1 =最低SES; 5 =最高SES）。805名学生入学（67%为女性; 66%为15-17岁; 51%为9-10年级）。在五分之一学校中，54%的学生没有月收入（家庭支助、赠款、兼职工作等）;在五分之一的学校中，38%的学校每月可获得100兰特（7.55美元）。男女学员对获得艾滋病毒和避孕服务的偏好相似。学习者强烈倾向于友好的，非判断性的工作人员提供的服务（比值比1.63; 95%置信区间：1.55-1.72），其中保密性得到保证（1.33; 1.26-1.40）。他们更喜欢放学后提供的服务（1.14; 1.04-1.25），包括增值服务，如免费Wi-Fi（1.19; 1.07-1.32），食物（1.23; 1.11-1.37）和青少年专用等候区（1.18; 1.07-1.32）。学习者没有具体的地点偏好，但不喜欢在社区（0.82; 0.74-0.91）或学校（0.88; 0.80-0.96）内接受服务。对大多数学生来说，无论学校附近如何，获得服务的费用都是一个阻碍因素;女生因费用≥ 3.85美元（0.79; 0.70-0.91）而却步;男生因费用≥ 100兰特（7.55美元）而却步（0.86; 0.74-1.00）。鼓励利用服务的偏好并没有显着不同的性别或学校附近的SES。工作人员的态度和保密性是影响学习者决定获得艾滋病毒和避孕服务的关键问题。解决医疗保健提供者如何应对寻求性健康和生殖健康服务的年轻人，对于改善青少年对这些服务的接受至关重要。在线版本包含补充材料，可通过10.1186/s12913-023-10414-w获得。
Many Adolescents in Sub-Saharan Africa do not access HIV and reproductive health services optimally. To improve uptake of these services, it is important to understand the Learners’ preferences for how services are delivered so that implementation strategies can reflect this. A discrete choice experiment (DCE) was used to elicit preferences. The DCE was completed between 07/2018 and 09/2019 and conducted in 10 high schools situated in neighbourhoods of varying socio-economic status (SES) in Gauteng (South Africa). Learners aged ≥ 15 years (Grades 9–12) were consented and enrolled in the DCE. Parental consent and assent were required if < 18 years old. Conditional logistic regression was used to determine preferred attributes for HIV and contraceptive service delivery. Results were stratified by gender and neighbourhood SES quintile (1 = Lowest SES; 5 = Highest SES). 805 Learners were enrolled (67% female; 66% 15–17 years; 51% in grades 9–10). 54% of Learners in quintile 1 schools had no monthly income (family support, grants, part-time jobs etc.); 38% in quintile 5 schools had access to R100 ($7.55) per month. Preferences for accessing HIV and contraceptive services were similar for male and female Learners. Learners strongly preferred services provided by friendly, non-judgmental staff (Odds ratio 1.63; 95% Confidence Interval: 1.55–1.72) where confidentiality was ensured (1.33; 1.26–1.40). They preferred services offered after school (1.14; 1.04–1.25) with value-added services like free Wi-Fi (1.19; 1.07–1.32), food (1.23; 1.11–1.37) and youth-only waiting areas (1.18; 1.07–1.32). Learners did not have a specific location preference, but preferred not to receive services within the community (0.82; 0.74–0.91) or school (0.88; 0.80–0.96). Costs to access services were a deterrent for most Learners irrespective of school neighbourhood; female Learners were deterred by costs ≥$3.85 (0.79; 0.70–0.91); males by costs ≥ R100 ($7.55) (0.86; 0.74-1.00). Preferences that encourage utilisation of services do not significantly differ by gender or school neighbourhood SES. Staff attitude and confidentiality are key issues affecting Learners’ decisions to access HIV and contraceptive services. Addressing how healthcare providers respond to young people seeking sexual and reproductive health services is critical for improving adolescents’ uptake of these services. The online version contains supplementary material available at 10.1186/s12913-023-10414-w.
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DOI：
10.1097/qad.0000000000002882
发表时间：
2021-07-01
期刊：
AIDS (London, England)
影响因子：
--
作者：
Cluver L;Shenderovich Y;Toska E;Rudgard WE;Zhou S;Orkin M;Haghighat R;Chetty AN;Kuo C;Armstrong A;Sherr L
通讯作者：
Sherr L
影响因子：
4.5
作者：
Johnson, F. Reed;Lancsar, Emily;Bridges, John F. P.
通讯作者：
Bridges, John F. P.
影响因子：
3.7
作者：
Chimbindi N;Mthiyane N;Birdthistle I;Floyd S;McGrath N;Pillay D;Seeley J;Zuma T;Dreyer J;Gareta D;Mutevedzi T;Fenty J;Herbst K;Smit T;Baisley K;Shahmanesh M
通讯作者：
Shahmanesh M
DOI：
10.1007/s40271-015-0118-z
发表时间：
2015-10
期刊：
The patient
影响因子：
--
作者：
de Bekker-Grob EW;Donkers B;Jonker MF;Stolk EA
通讯作者：
Stolk EA
影响因子：
3.7
作者：
Musakwa NO;Bor J;Nattey C;Lönnermark E;Nyasulu P;Long L;Evans D
通讯作者：
Evans D