Using Discrete Choice Experiments to Identify HIV Testing Preferences in Tanzania

使用离散选择实验确定坦桑尼亚的艾滋病毒检测偏好

• 批准号: 8423320
• 负责人: Jan Ostermann
• 金额: $ 19.73万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-02-08 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8423320
• 关键词: AIDS prevention; AIDS/HIV problem; Adult; Africa South of the Sahara; Age; Behavioral; Caring; Client; Clinic; Communities; Counseling; Data; Decision Making; Economics; Effectiveness; Enrollment; Epidemic; Focus Groups; Future; HIV; Health; Home environment; Household; Human immunodeficiency virus test; Individual; Interdisciplinary Study; Intervention; Interview; Life; Medical; Methods; Modality; Patients; Pattern; Persons; Population; Populations at Risk; Qualitative Methods; Randomized Controlled Trials; Relative (related person); Research; Resources; Respondent; Risk; Surveys; Tanzania; Target Populations; Techniques; Testing; Time; United States; Utility Theories; Work; base; cost effectiveness; design; experience; high risk; implementation research; improved; informant; innovation; novel; patient oriented; preference; programs; randomized trial; research study; response; uptake

DESCRIPTION (provided by applicant): Universal HIV testing and immediate treatment of HIV-infected individuals could dramatically reduce the HIV epidemic, yet HIV testing uptake in sub-Saharan Africa remains low. In Tanzania, despite improved availability of HIV testing options, nearly two thirds of adults have never tested for HIV. Novel HIV testing options specifically designed to match the preferences of high-risk and hard-to-reach populations hold the potential to improve the acceptability and uptake of HIV testing. To extend our previous work, which assessed uptake of HIV voluntary counseling and testing (VCT) across varied venues in the Kilimanjaro Region of Tanzania (free-standing, mobile, home-based, and clinic-based VCT), we propose to apply an innovative method for preference elicitation known as Discrete Choice Experiments (DCEs, sometimes referred to as conjoint analysis) to HIV testing in this region. Grounded in the economic theory of utility maximization, the DCE method identifies key modifiable features of HIV testing options, presents survey respondents with various combinations of these features (each representing a hypothetical HIV testing option), and asks them to choose their preferred alternatives. Responses are analyzed to estimate the relative value placed on individual testing features, and to determine what combinations of features most influence decision-making and uptake. The primary aims of this two-year study are to: 1) Use qualitative methods to identify key modifiable features of HIV testing programs that influence testing decisions; 2) Develop a DCE survey and elicit preferences from 800 randomly selected residents of the Kilimanjaro Region of Tanzania; and 3) Estimate preferences for existing as well as hypothetical, but feasible, HIV testing interventions. Differences in testig preferences between persons who have never tested for HIV and those who have previously tested for HIV will be described. The study will be implemented in the Kilimanjaro Region of Tanzania by a multidisciplinary research team that combines a track record of successful HIV testing research in Tanzania and experience with DCEs in diverse fields. The DCE method, applied in this context, holds promise to identify HIV testing preferences of hard-to-reach and at-risk populations for whom customized testing interventions can be devised. The data from this study will form the basis for implementation research on the benefits of tailoring HIV testing interventions to the specific preferences of the intended target populations. The effectiveness and cost- effectiveness of such interventions can subsequently be evaluated in a randomized controlled trial. Adapting available testing options to heterogeneous communities in sub-Saharan Africa has the potential to broadly improve the uptake of HIV testing, thereby bringing more persons living with HIV/AIDS into care and equipping persons living without HIV/AIDS with important information about HIV prevention.

描述（由申请人提供）：艾滋病毒感染者的普遍艾滋病毒测试和立即治疗可以大大降低艾滋病毒的流行，但撒哈拉以南非洲的艾滋病毒测试摄入量仍然很低。在坦桑尼亚，尽管艾滋病毒测试选择的可用性提高了，但近三分之二的成年人从未对HIV进行测试。专门设计的新型艾滋病毒测试选项旨在与高风险和难以到达的人群的偏好相匹配，具有提高HIV测试的可接受性和摄取的潜力。 为了扩展我们先前的工作，该工作评估了坦桑尼亚乞力马扎罗州地区的各种场所的HIV自愿咨询和测试（VCT）（自由居住，基于家庭的，基于家庭的和基于诊所的VCT），我们建议将创新方法应用于偏好的启发性选择，有时将其引用为DCES（有时是DCES），以分析该领域，以分析为Conjoints conjoints conjoints conjoints conjoints conjoints。 DCE方法基于实用性最大化的经济理论，确定了艾滋病毒测试选项的关键可修改特征，向受访者提供了这些特征的各种组合（每种代表假设的艾滋病毒测试选项），并要求他们选择他们的首选替代方案。分析响应以估计在单个测试特征上放置的相对值，并确定哪些功能的组合最大，影响决策和吸收。 这项为期两年的研究的主要目的是：1）使用定性方法来识别影响测试决策的艾滋病毒测试计划的关键可修改特征； 2）制定了坦桑尼亚乞力马扎罗州800个随机选择居民的DCE调查并引起偏好； 3）估计现有以及可行的HIV测试干预措施的偏好。从未对HIV进行测试的人与先前对HIV进行过测试的人之间的睾丸偏好差异。 该研究将由一个多学科研究团队在坦桑尼亚的乞力马扎罗州地区实施，该团队结合了坦桑尼亚成功的HIV测试研究的往绩以及在不同领域的DCE经验。在这种情况下应用的DCE方法有望确定可以为其定制的测试干预措施的难以到达的艾滋病毒测试偏好。这项研究的数据将构成对针对预期目标人群的特定偏好调整艾滋病毒测试干预措施的益处的实施研究的基础。随后可以在随机对照试验中评估此类干预措施的有效性和成本效益。 对撒哈拉以南非洲的异质社区进行适应可用的测试方案有可能广泛改善艾滋病毒测试的吸收，从而使更多的艾滋病毒/艾滋病患者进入护理，并为没有艾滋病毒/艾滋病的人/艾滋病的人提供有关艾滋病毒预防的重要信息。