Patient preferences for HIV service delivery models; a Discrete Choice Experiment in Kisumu, Kenya.
| Title: | Patient preferences for HIV service delivery models; a Discrete Choice Experiment in Kisumu, Kenya. |
|---|---|
| Authors: | Mando RO; Research Care and Training Program, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.; Moghadassi M; Department of Gynecology, Obstetrics, and Reproductive Sciences, University of California San Francisco, California, United States of America.; Juma E; Research Care and Training Program, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.; Ogollah C; Research Care and Training Program, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.; Packel L; The University of California Berkeley, Berkeley, California, United States of America.; Kulzer JL; Department of Gynecology, Obstetrics, and Reproductive Sciences, University of California San Francisco, California, United States of America.; The University of California Berkeley, Berkeley, California, United States of America.; Kadima J; Research Care and Training Program, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.; Odhiambo F; Research Care and Training Program, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.; Eshun-Wilson I; Division of Infectious Diseases, Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, United States of America.; Kim HY; School of Medicine, New York University, New York, New York, United States of America.; Cohen CR; Department of Gynecology, Obstetrics, and Reproductive Sciences, University of California San Francisco, California, United States of America.; Bukusi EA; Research Care and Training Program, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.; Department of Gynecology, Obstetrics, and Reproductive Sciences, University of California San Francisco, California, United States of America.; The University of California Berkeley, Berkeley, California, United States of America.; Geng E; Division of Infectious Diseases, Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, United States of America. |
| Source: | PLOS global public health [PLOS Glob Public Health] 2022 Oct 27; Vol. 2 (10), pp. e0000614. Date of Electronic Publication: 2022 Oct 27 (Print Publication: 2022). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 9918283779606676 Publication Model: eCollection Cited Medium: Internet ISSN: 2767-3375 (Electronic) Linking ISSN: 27673375 NLM ISO Abbreviation: PLOS Glob Public Health Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: San Francisco, California : Public Library of Science, [2021]- |
| Abstract: | Novel "differentiated service delivery" models for HIV treatment that reduce clinic visit frequency, minimize waiting time, and deliver treatment in the community promise retention improvement for HIV treatment in Sub-Saharan Africa. Quantitative assessments of differentiated service delivery (DSD) feature most preferred by patient populations do not widely exist but could inform selection and prioritization of different DSD models. We used a discrete choice experiment (DCE) to elicit patient preferences of HIV treatment services and how they differ across DSD models. We surveyed 18+year-olds, enrolled in HIV care for ≥6 months between February-March, 2019 at four facilities in Kisumu County, Kenya. DCE offered patients a series of comparisons between three treatment models, each varying across seven attributes: ART refill location, quantity of dispensed ART at each refill, medication pick-up hours, type of adherence support, clinical visit frequency, staff attitude, and professional cadre of person providing ART refills. We used hierarchical Bayesian model to estimate attribute importance and relative desirability of care characteristics, latent class analysis (LCA) for groups of preferences and mixed logit model for willingness to trade analysis. Of 242 patients, 128 (53.8%) were females and 150 (62.8%) lived in rural areas. Patients placed greatest importance on ART refill location [19.5% (95% CI 18.4, 10.6) and adherence support [19.5% (95% CI 18.17, 20.3)], followed by staff attitude [16.1% (95% CI 15.1, 17.2)]. In the mixed logit, patients preferred nice attitude of staff (coefficient = 1.60), refill ART health center (Coeff = 1.58) and individual adherence support (Coeff = 1.54), 3 or 6 months for ART refill (Coeff = 0.95 and 0.80, respectively) and pharmacists (instead of lay health workers) providing ART refill (Coeff = 0.64). No differences were observed by gender or urbanicity. LCA revealed two distinct groups (59.5% vs. 40.5%). Participants preferred 3 to 6-month refill interval or clinic visit spacing, which DSD offers stable patients. While DSD has encouraged community ART group options, our results suggest strong preferences for ART refills from health-centers or pharmacists over lay-caregivers or community members. These preferences held across gender&urban/rural subpopulations.; (Copyright: © 2022 Mando et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) |
| Competing Interests: | The authors have declared that no competing interests exist. |
| References: | Health Policy Plan. 2009 Mar;24(2):151-8. (PMID: 19112071); AIDS Patient Care STDS. 2012 Jan;26(1):20-8. (PMID: 22149903); AIDS Behav. 2010 Aug;14(4):807-15. (PMID: 19533322); Public Health. 2019 Feb;167:50-54. (PMID: 30639803); Curr Opin HIV AIDS. 2019 Jan;14(1):60-65. (PMID: 30394947); AIDS Behav. 2021 Feb;25(2):397-413. (PMID: 32812124); PLoS One. 2020 Jan 28;15(1):e0228148. (PMID: 31990930); PLoS Med. 2019 Jul 23;16(7):e1002874. (PMID: 31335865); Ann Pharmacother. 2009 Jun;43(6):1036-44. (PMID: 19491319); PLoS One. 2021 Aug 25;16(8):e0255650. (PMID: 34432795); J Int AIDS Soc. 2017 Jul 21;20(Suppl 4):21647. (PMID: 28770599); BMC Health Serv Res. 2019 Feb 4;19(1):95. (PMID: 30717715); J Int AIDS Soc. 2017 Jul 21;20(Suppl 4):21650. (PMID: 28770594); J Acquir Immune Defic Syndr. 2014 Jun 1;66(2):e58-60. (PMID: 24378724); PLoS One. 2018 Jan 10;13(1):e0190286. (PMID: 29320531); Int J STD AIDS. 2014 Feb;25(2):105-12. (PMID: 23970633); J Int AIDS Soc. 2017 Jul 21;20(Suppl 4):21649. (PMID: 28770595); Patient Prefer Adherence. 2016 Jul 11;10:1197-203. (PMID: 27468229); Perm J. 2020 Dec;24:1-3. (PMID: 33482953); PLoS Med. 2018 Aug 13;15(8):e1002636. (PMID: 30102693); BMC Infect Dis. 2017 Dec 13;17(1):766. (PMID: 29237401); AIDS Care. 2018 Dec;30(12):1477-1487. (PMID: 30037312); Int J Environ Res Public Health. 2021 Mar 03;18(5):. (PMID: 33802322); J Acquir Immune Defic Syndr. 2019 Aug 15;81(5):540-546. (PMID: 31021988) |
| Entry Date(s): | Date Created: 20230324 Latest Revision: 20230327 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10021384 |
| DOI: | 10.1371/journal.pgph.0000614 |
| PMID: | 36962597 |
| Database: | MEDLINE |
Journal Article