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

摘要

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