Divergent preferences for enhanced HIV testing options among high-risk populations in northern Tanzania: a short report

ABSTRACT

To achieve the UNAIDS target of diagnosing 95% of all persons living with HIV, enhanced HIV testing services with greater attractional value need to be developed and implemented. We conducted a discrete choice experiment (DCE) to quantify preferences for enhanced HIV testing features across two high-risk populations in the Kilimanjaro Region in northern Tanzania. We designed and fielded a survey with 12 choice tasks to systematically recruited female barworkers and male mountain porters. Key enhanced features included: testing availability on every day of the week, an oral test, integration of a general health check or an examination for sexually transmitted infections (STI) with HIV testing, and provider-assisted confidential partner notification in the event of a positive HIV test result. Across 300 barworkers and 440 porters surveyed, mixed logit analyses of 17,760 choices indicated strong preferences for everyday testing availability, health checks, and STI examinations. Most participants were averse to oral testing and confidential partner notification by providers. Substantial preference heterogeneity was observed within each risk group. Enhancing HIV testing services to include options for everyday testing, general health checks, and STI examinations may increase the appeal of HIV testing offers to high-risk populations.

Trial registration: ClinicalTrials.gov identifier: NCT02714140.

KEYWORDS:

• HIV counseling and testing
• discrete choice experiment
• preference heterogeneity
• sub-Saharan Africa
• Tanzania

Acknowledgments

The authors are grateful to the study participants and to the study research assistants, Martha Masaki, Beatrice Mandao, Elizabeth Mbuya, Honoratha Israel, Yombya Madukwa, Mohamed Mcharo, Upendo Nnko, Stephen Sikumbili, Edward Singo, Blandina Zenze, Leonia Rugalabamu, Suzan Kitomari, Stanny Komu, and Beldad Mmari, for input on study procedures and study implementation.

The authors thank the staff of the Kilimanjaro Clinical Research Institute, especially Professor Blandina Mmbaga, Dr. Aisa Shayo, and Zuhura Lintu, the University of South Carolina’s Arnold School of Public Health, especially the Department of Health Services Policy & Management and the Center for Health Care Quality, the Duke Global Health Institute and Duke University’s Center for Health Policy and Inequalities Research, for administrative support; and members of the Duke Center for AIDS Research and the study’s Scientific Advisory Board for feedback on study feasibility, design, analytic methods, and implementation.

Finally, the authors acknowledge Dr. Credianus Mgimba (Regional Medical Officer, Kilimanjaro Region), Dr. Best Magoma (former Regional Medical Officer, Kilimanjaro Region), Dr. Eligy Mosille (Regional AIDS Control Coordinator, Kilimanjaro Region), Ms. Dafrosa Itemba (Director, Tanzania Women Research Foundation), and members of the Moshi District Council administration, for their support of the study’s development and implementation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health in the United States under Award Numbers R01MH106388 and R21MH96631 and by the Center for AIDS Research, Duke University (CFAR), an NIH funded program (P30AI064518). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.