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接受产前护理的孕妇及其男性伴侣的艾滋病毒检测偏好:乌干达的一项离散选择实验

HIV testing preferences among pregnant women attending antenatal care and their male partners: a discrete choice experiment in Uganda.

作者信息

Korte Jeffrey E, Strauss Michael, Ba Aissatou, Buregyeya Esther, Matovu Joseph Kb, Kisa Rose, Musoke William, Chemusto Harriet, Vrana-Diaz Caroline J, Malek Angela M, Wanyenze Rhoda K, George Gavin

机构信息

Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.

Health Economics and HIV and AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa.

出版信息

Afr J AIDS Res. 2019 Dec;18(4):332-340. doi: 10.2989/16085906.2019.1686032.


DOI:10.2989/16085906.2019.1686032
PMID:31779576
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6890225/
Abstract

HIV testing rates remain stubbornly low among men - a crucial target population for reaching the ambitious global and regional goals of the HIV programme. In an era of declining donor funding, identifying cost-effective strategies to increase testing rates amongst men remains paramount. Antenatal care is an effective entry-point for the delivery of HIV testing services for women, and partner testing presents an important opportunity to reach their male partners. We present the results of a discrete choice experiment in Uganda, examining preferences among 824 pregnant women and 896 male partners regarding service delivery characteristics of HIV testing. Both men and women preferred nurse administered testing to self-testing (OR = 0.835; < 0.001), oral testing over a finger-prick test (OR = 1.176 < 0.001) and testing with a partner over testing alone (OR = 1.230; < 0.001). Men had a preference for testing at home compared to testing at a clinic (OR = 1.099; = 0.024), but women were indifferent regarding the testing location. The cost of testing had the biggest effect on preferences. Free testing was preferred over a cost of US$2.90 (OR = 0.781; < 0.001) or US$2.00 (OR = 0.670; < 0.001). Offering an incentive of US$3.40 increased men's preferences compared to a free test (OR = 1.168; < 0.001), although this did not affect women's preferences. Partner testing linked to antenatal care is a potential strategy to increase testing coverage among men, particularly given the preference for partner testing - provided costs to clients remain low. Future cost-effectiveness evaluations should investigate the economic impact of reaching men using these strategies.

摘要

在男性群体中,艾滋病毒检测率一直维持在较低水平,而男性是实现艾滋病规划雄心勃勃的全球和区域目标的关键目标人群。在捐助资金不断减少的时代,确定具有成本效益的策略以提高男性检测率仍然至关重要。产前护理是为女性提供艾滋病毒检测服务的有效切入点,而性伴侣检测则是接触其男性伴侣的重要契机。我们展示了在乌干达进行的一项离散选择实验的结果,该实验调查了824名孕妇及其896名男性伴侣对艾滋病毒检测服务提供特征的偏好。男性和女性都更倾向于由护士进行检测而非自我检测(比值比=0.835;P<0.001),更倾向于口服检测而非指尖采血检测(比值比=1.176;P<0.001),以及更倾向于与性伴侣一起检测而非单独检测(比值比=1.230;P<0.001)。与在诊所检测相比,男性更倾向于在家中检测(比值比=1.099;P=0.024),但女性对检测地点无差异。检测成本对偏好影响最大。免费检测比2.90美元(比值比=0.781;P<0.001)或2.00美元(比值比=0.670;P<0.001)的成本更受青睐。与免费检测相比,提供3.40美元的激励措施增加了男性的偏好(比值比=1.168;P<0.001),尽管这并未影响女性的偏好。与产前护理相关的性伴侣检测是提高男性检测覆盖率的潜在策略,特别是考虑到对性伴侣检测的偏好——前提是客户成本仍然较低。未来的成本效益评估应调查使用这些策略接触男性的经济影响。

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[1]
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[2]
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[5]
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[6]
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[7]
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[9]
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本文引用的文献

[1]
HIV Oral Self-Testing for Male Partners of Women Attending Antenatal Care in Central Uganda: Uptake of Testing and Linkage to Care in a Randomized Trial.

J Acquir Immune Defic Syndr. 2020-7-1

[2]
Stated and revealed preferences for HIV testing: can oral self-testing help to increase uptake amongst truck drivers in Kenya?

BMC Public Health. 2018-11-6

[3]
Health care users' knowledge, attitudes and perceptions of HIV self-testing at selected gateway clinics at eThekwini district, KwaZulu-Natal province, South Africa.

SAHARA J. 2018-12

[4]
Impact of HIV Self-Test Distribution to Male Partners of ANC Clients: Results of a Randomized Controlled Trial in Kenya.

J Acquir Immune Defic Syndr. 2018-12-1

[5]
'If I had not taken it [HIVST kit] home, my husband would not have come to the facility to test for HIV': HIV self-testing perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda.

Glob Health Action. 2018

[6]
Acceptability of HIV self-testing among men and women in KwaZulu-Natal, South Africa.

AIDS Care. 2019-2

[7]
How well do discrete choice experiments predict health choices? A systematic review and meta-analysis of external validity.

Eur J Health Econ. 2018-1-29

[8]
HIV testing preferences among long distance truck drivers in Kenya: a discrete choice experiment.

AIDS Care. 2018-1

[9]
Offering self-administered oral HIV testing to truck drivers in Kenya to increase testing: a randomized controlled trial.

AIDS Care. 2018-1

[10]
HIV self-testing values and preferences among sex workers, fishermen, and mainland community members in Rakai, Uganda: A qualitative study.

PLoS One. 2017-8-16

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