Stated and revealed preferences for HIV testing: can oral self-testing help to increase uptake amongst truck drivers in Kenya?
Stated and revealed preferences for HIV testing: can oral self-testing help to increase uptake amongst truck drivers in Kenya?
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DOI：
10.1186/s12889-018-6122-1
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发表时间：
2018-11-06
影响因子：
4.5
通讯作者：
Kelvin EA
中科院分区：
文献类型：
--
作者：
Strauss M;George G;Mantell JE;Romo ML;Mwai E;Nyaga EN;Odhiambo JO;Govender K;Kelvin EA
非洲的长途卡车司机尤其面临感染艾滋病毒的风险，提供自我检测可能有助于增加这一难以接触到的人群的检测覆盖率。这项研究的目的有两个：(1)考察肯尼亚卡车司机对艾滋病毒检测服务提供模式的偏好结构，以及它们对艾滋病毒自我检测的推出意味着什么，以及(2)将从假设的离散选择实验中收集的偏好数据与随机对照试验(RCT)干预部分参与者的实际选择进行比较，这些参与者提供了艾滋病毒检测选择。使用来自150名卡车司机的数据，本文检验了离散选择实验中关于艾滋病毒检测的陈述偏好是否预测了当提供艾滋病毒检测选择时所选择的实际检测。条件Logit模型用于主效应分析，分层模型根据试验中做出的艾滋病毒检测选择运行，以评估所选测试是否导致偏好的属性不同。在所有参与者中，明确偏好的最大驱动因素是成本。然而，在那些实际选择了随机对照研究中的自我测试的人和那些选择了提供者管理的测试的人之间，有两个偏好存在分歧：测试的类型(p<； 0.001)和咨询的类型(p= 0.003)。自我测试者更喜欢口头测试而不是指刺测试(OR1.26p= 0.005)，而非自我测试者更喜欢指刺测试(OR0.56p <； 0.001)。与电话咨询相比，非自我测试者更喜欢面对面的咨询(OR0.64 p <； 0.001)，而自我测试者对咨询的类型不感兴趣。在两组人中，关于谁管理测试的偏好并不显著。我们发现，陈述的偏好结构有助于解释参与者对他们接受的艾滋病毒检测类型所做的实际选择。提供口头测试可能是提高某些卡车司机群体测试意愿的有效策略。然而，面对面咨询和支持的重要性，以及对口腔测试无法检测出艾滋病毒感染的担忧，可能意味着继续在路边健康中心提供指刺测试将最符合那些已经在这些设施接受治疗的人的偏好。需要更多的研究来探索谁管理艾滋病毒检测(提供者和自己)是否有任何不同。这项试验在国际发展影响评价登记处登记(RIDE ID#55847d64a454f)。
Long-distance truck drivers in Africa are particularly at risk of HIV acquisition and offering self-testing could help increase testing coverage in this hard-to-reach population. The aims of this study are twofold: (1) to examine the preference structures of truck drivers in Kenya regarding HIV testing service delivery models and what they mean for the roll-out of HIV self-testing, and (2) to compare the preference data collected from a hypothetical discrete choice experiment with the actual choices made by participants in the intervention arm of a randomised controlled trial (RCT) who were offered HIV testing choices. Using data from 150 truck drivers, this paper examines whether the stated preferences regarding HIV testing in a discrete choice experiment predict the actual test selected when offered HIV testing choices. Conditional logit models were used for main effects analysis and stratified models were run by HIV testing choices made in the trial to assess if the attributes preferred differed by test chosen. The strongest driver of stated preference among all participants was cost. However, two preferences diverged between those who actually chose self-testing in the RCT and those who chose a provider administered test: the type of test (p < 0.001) and the type of counselling (p = 0.003). Self-testers preferred oral-testing to finger-prick testing (OR 1.26 p = 0.005), while non-self-testers preferred finger-prick testing (OR 0.56 p < 0.001). Non-self-testers preferred in-person counselling to telephonic counselling (OR 0.64 p < 0.001), while self-testers were indifferent to type of counselling. Preferences in both groups regarding who administered the test were not significant. We found stated preference structures helped explain the actual choices participants made regarding the type of HIV testing they accepted. Offering oral testing may be an effective strategy for increasing willingness to test among certain groups of truck drivers. However, the importance of in-person counselling and support, and concern that an oral test cannot detect HIV infection may mean that continuing to offer finger-prick testing at roadside wellness centres will best align with the preferences of those already attending these facilities. More research is needed to explore whether who administers the HIV test (provider versus self) makes any difference. This trial is registered with the Registry for International Development Impact Evaluations (RIDE ID#55847d64a454f).
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DOI：
10.1097/qai.0000000000001601
发表时间：
2018-03-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Lippman SA;Lane T;Rabede O;Gilmore H;Chen YH;Mlotshwa N;Maleke K;Marr A;McIntyre JA
通讯作者：
McIntyre JA
影响因子：
2.1
作者：
Mark, TL;Swait, J
通讯作者：
Swait, J
影响因子：
4.4
作者：
Kelvin EA;George G;Mwai E;Nyaga EN;Mantell JE;Romo ML;Odhiambo JO;Govender K
通讯作者：
Govender K
影响因子：
1.7
作者：
Kelvin EA;George G;Mwai E;Nyaga E;Mantell JE;Romo ML;Odhiambo JO;Starbuck L;Govender K
通讯作者：
Govender K
影响因子：
4.4
作者：
Botão C;Horth RZ;Frank H;Cummings B;Inguane C;Sathane I;McFarland W;Fisher Raymond H;Young PW
通讯作者：
Young PW