Heterogeneity in Preferences for HIV Self-Testing Among Ugandan Men
Author(s)
Shiven Bhardwaj, PharmD, MAS1, Enrique M. Saldarriaga, PhD1, Yilin Chen, PhD2, Jackson Mugisha, B.S.3, Julius Magembe, B.Sc.3, George Eram, B.Sc.3, Agnes Nakyanzi, B.Sc.3, Andrew Mujugira, PhD3, Fern Terris-Presholt, PhD4, Monisha Sharma, PhD5.
1The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, WA, USA, 2Curta, Inc., Seattle, WA, USA, 3The Infectious Disease Institute Limited, Makerere University, Kampala, Uganda, 4University of Warwick, Warwick, United Kingdom, 5Department of Global Health, University of Washington, Seattle, WA, USA.
1The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, WA, USA, 2Curta, Inc., Seattle, WA, USA, 3The Infectious Disease Institute Limited, Makerere University, Kampala, Uganda, 4University of Warwick, Warwick, United Kingdom, 5Department of Global Health, University of Washington, Seattle, WA, USA.
Presentation Documents
OBJECTIVES: Men’s HIV testing coverage remains low in Sub-Saharan Africa. HIV Self-Testing (HIVST) is an accurate and convenient method that can increase testing, but optimal distribution strategies are unknown. We studied heterogeneity of preferences in HIVST uptake among heterosexual men in urban Uganda in 2022-2023.
METHODS: We conducted a discrete choice experiment (DCE) to assess men’s preferences regarding six HIVST attributes (location for test receipt, HIVST distributor, distributor sex, HIVST type and support mode). The DCE consisted of eight choice sets with two alternatives and dual-response opt-out. We conducted a latent class analysis (LCA) to identify groups within the sample with distinctive preference patterns for HIVST and assess preference heterogeneity by examining specific demographic characteristics within the latent classes (e.g., age, number of children, partnership status).
RESULTS: We identified three classes through the LCA. Participants in class 1 (n=29, 7.5%) preferred blood over oral HIVST and favored pharmacy distribution (p<0.05); they were more likely to be younger, single, childfree, income and food secure, and have formal employment than those in classes 2 and 3. Participants in Class 2 (n=84, 21.4%) and Class 3 (n=283, 71.1%) were disinclined to receive tests from their partners and conducting HIVST at home, and preferred oral over blood test (both p-values<0.05). In class 3, a significant number of participants opted out, indicating lack of preference for HIVST in a large proportion of men. Participants in all classes preferred in-person follow-up support after HIVST (p<0.05).
CONCLUSIONS: Our results emphasize the importance of a targeted approach to dissemination of tests. Among younger, higher earning, single men distribution of tests through pharmacies may promote further uptake. However, providing in-person follow-up support may be the best way of increasing uptake across the entire population. These findings can inform HIVST distribution strategies to increase uptake of HIVST in Uganda and comparable contexts.
METHODS: We conducted a discrete choice experiment (DCE) to assess men’s preferences regarding six HIVST attributes (location for test receipt, HIVST distributor, distributor sex, HIVST type and support mode). The DCE consisted of eight choice sets with two alternatives and dual-response opt-out. We conducted a latent class analysis (LCA) to identify groups within the sample with distinctive preference patterns for HIVST and assess preference heterogeneity by examining specific demographic characteristics within the latent classes (e.g., age, number of children, partnership status).
RESULTS: We identified three classes through the LCA. Participants in class 1 (n=29, 7.5%) preferred blood over oral HIVST and favored pharmacy distribution (p<0.05); they were more likely to be younger, single, childfree, income and food secure, and have formal employment than those in classes 2 and 3. Participants in Class 2 (n=84, 21.4%) and Class 3 (n=283, 71.1%) were disinclined to receive tests from their partners and conducting HIVST at home, and preferred oral over blood test (both p-values<0.05). In class 3, a significant number of participants opted out, indicating lack of preference for HIVST in a large proportion of men. Participants in all classes preferred in-person follow-up support after HIVST (p<0.05).
CONCLUSIONS: Our results emphasize the importance of a targeted approach to dissemination of tests. Among younger, higher earning, single men distribution of tests through pharmacies may promote further uptake. However, providing in-person follow-up support may be the best way of increasing uptake across the entire population. These findings can inform HIVST distribution strategies to increase uptake of HIVST in Uganda and comparable contexts.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD67
Topic
Health Service Delivery & Process of Care
Disease
SDC: Infectious Disease (non-vaccine)