Monash University, Melbourne, Australia.
University of Technology, Sydney, Australia.
Value Health. 2020 Jul;23(7):870-879. doi: 10.1016/j.jval.2020.04.1826. Epub 2020 Jul 17.
OBJECTIVES: Human immunodeficiency virus self-testing (HIVST) is a promising approach to improve HIV testing coverage. We aimed to understand HIV testing preferences of men who have sex with men (MSM) to optimize HIVST implementation. METHODS: Discrete choice experiments (DCEs) were conducted among HIV-negative MSM living in Australia and aged ≥18 years. Men completed 1 of 2 DCEs: DCETest for preferred qualities of HIV testing (price, speed, window period, test type, and collector of specimen) and DCEKits for preferred qualities of HIVST kits (price, location of access, packaging, and usage instructions). Latent class conditional logit regression was used to explore similarities (or "classes") in preference behavior. RESULTS: Overall, the study recruited 1606 men: 62% born in Australia, who had an average age of 36.0 years (SD 11.7), and a self-reported median of 4 (interquartile range 2-8) sexual partners in the last 6 months. The respondents to DCETest was described by 4 classes: "prefer shorter window period" (36%), "prefer self-testing" (27%), "prefer highly accurate tests" (22%), and "prefer low prices" (15%). Respondents to DCEKits were described by 4 classes: "prefer low prices" (48%), "prefer retail access (from pharmacy or online stores)" (29%), "prefer access at sex venues" (15%), and "prefer to buy from healthcare staff" (12%). Preferences varied by when someone migrated to Australia, age, frequency of testing, and number of sexual partners. CONCLUSION: A subset of MSM, particularly infrequent testers, value access to HIVST. Expanding access to HIVST kits through online portals and pharmacies and at sex venues should be considered.
目的:人类免疫缺陷病毒自我检测(HIVST)是提高 HIV 检测覆盖率的一种很有前景的方法。我们旨在了解男男性行为者(MSM)对 HIV 检测的偏好,以优化 HIVST 的实施。
方法:在澳大利亚居住的 HIV 阴性、年龄≥18 岁的 MSM 中进行了离散选择实验(DCE)。男性完成了 1 项 DCE 中的 1 项:DCETest 用于评估 HIV 检测的首选质量(价格、速度、窗口期、检测类型和标本采集者)和 DCEKits 用于评估 HIVST 试剂盒的首选质量(价格、获取地点、包装和使用说明)。潜在类别条件逻辑回归用于探索偏好行为的相似性(或“类别”)。
结果:总体而言,该研究共招募了 1606 名男性:62%出生于澳大利亚,平均年龄为 36.0 岁(标准差 11.7),自我报告的近 6 个月内性伴侣中位数为 4 个(四分位距 2-8)。DCETest 的回答者被描述为 4 个类别:“更喜欢较短的窗口期”(36%)、“更喜欢自我检测”(27%)、“更喜欢高度准确的检测”(22%)和“更喜欢低价格”(15%)。DCEKits 的回答者被描述为 4 个类别:“更喜欢低价格”(48%)、“更喜欢零售途径(从药店或在线商店购买)”(29%)、“更喜欢在性场所获得”(15%)和“更喜欢从医护人员处购买”(12%)。偏好因移民澳大利亚的时间、年龄、检测频率和性伴侣数量而异。
结论:一小部分 MSM,特别是检测频率较低的 MSM,重视获得 HIVST 的机会。应考虑通过在线门户和药店以及性场所扩大 HIVST 试剂盒的获取途径。
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