Yang Jingwen, Qiu Chenquan, Tang Renhai, Dong Wenbin, Yao Enlong, Wang Huyunzhao, Lin Shuwen, Xiao Minyang, Zhang Zuyang, Niu Jin, Fu Liru, Song Lijun, Li Xuehua, Shi Yuhua, Wang Xiaowen
Kunming Medical University, Chenggong Municipal, No.1168, Yuhua Street, Kunming, Yunnan Province, China.
Qujing Municipal Center for Disease Control and Prevention, Qujing, Yunnan Province, China.
BMC Health Serv Res. 2025 Feb 7;25(1):216. doi: 10.1186/s12913-025-12357-w.
The detection and early identification of people living with HIV/AIDS (PLWH) and their rapid engagement in antiretroviral treatment are indispensable for fighting HIV transmission. This study aimed to elicit preferences regarding HIV testing among community residents to identify a model of community-based HIV testing services that would appeal to this population.
A discrete-choice experiment (DCE) was conducted in the communities of Yunnan Province, China. The participants were asked to make nine choices between two unlabelled alternatives that differed in seven attributes: distance to the testing venue, confidentiality, institution, administrator, support services, testing days, and testing cost. The data were analysed using a random parameter logit model. The preference regression coefficient (β) was used to compare the importance of attribute levels. Relative importance (RI) was used to indicate the degree of importance of each attribute to the participants.
The results indicate confidentiality was the most important attribute (RI = 39.21%), followed by testing cost (RI = 25.15%), administrator (RI = 11.91%), institution (RI = 11.29%), support services (RI = 8.02%), distance (RI = 4.25%), and testing day (RI = 0.16%). The participants in our study showed a preference for confidentiality regarding the testing status (β = 1.82, p < 0.001), for the test being available at hospitals (β = 0.72, p < 0.001), and for the test being administered by physicians (β = 0.74, p < 0.001). We also observed that having support services was preferable (β = 0.50, p < 0.01) to support services not being available. Free HIV testing was the most preferred cost attribute (β = 1.61, p < 0.001). The distance and testing days were not significantly different (p > 0.05).
Community residents preferred an HIV testing service run by physicians in high-level health care institutions with excellent confidentiality, low cost, and available support services. Confidentiality remained the most important attribute of the HIV testing service. Worrying that others know the test results is a significant factor influencing testing decision-making and the uptake of testing services. Adjusting the model of community-based HIV testing services according to the preferences of the target population could make it more efficient and effective for the general public, allowing for early detection of HIV infection.
检测并尽早识别艾滋病毒/艾滋病感染者（PLWH），并使其迅速接受抗逆转录病毒治疗，对于抗击艾滋病毒传播至关重要。本研究旨在了解社区居民对艾滋病毒检测的偏好，以确定一种能吸引该人群的基于社区的艾滋病毒检测服务模式。
在中国云南省的社区中进行了一项离散选择实验（DCE）。参与者被要求在两个未标记的选项之间做出九次选择，这两个选项在七个属性上有所不同：到检测地点的距离、保密性、机构、管理人员、支持服务、检测日期和检测成本。使用随机参数logit模型对数据进行分析。偏好回归系数（β）用于比较属性水平的重要性。相对重要性（RI）用于表明每个属性对参与者的重要程度。
结果表明，保密性是最重要的属性（RI = 39.21%），其次是检测成本（RI = 25.15%）、管理人员（RI = 11.91%）、机构（RI = 11.29%）、支持服务（RI = 8.02%）、距离（RI = 4.25%）和检测日期（RI = 0.16%）。我们研究中的参与者对检测状态的保密性表现出偏好（β = 1.82，p < 0.001），对在医院进行检测表现出偏好（β = 0.72，p < 0.001），对由医生进行检测表现出偏好（β = 0.74，p < 0.001）。我们还观察到，有支持服务比没有支持服务更可取（β = 0.50，p < 0.01）。免费艾滋病毒检测是最受欢迎的成本属性（β = 1.61，p < 0.001）。距离和检测日期没有显著差异（p > 0.05）。
社区居民更喜欢由高水平医疗机构的医生提供的艾滋病毒检测服务，该服务具有出色的保密性、低成本和可用的支持服务。保密性仍然是艾滋病毒检测服务最重要的属性。担心他人知道检测结果是影响检测决策和检测服务接受度的一个重要因素。根据目标人群的偏好调整基于社区的艾滋病毒检测服务模式，可能会使其对普通公众更高效、更有效，从而实现艾滋病毒感染的早期检测。
