학술논문

Exploring Relative Preferences for HIV Service Features Using Discrete Choice Experiments: a Synthetic Review
Document Type
article
Source
Current HIV/AIDS Reports. 17(5)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Immunology
HIV/AIDS
Substance Misuse
Clinical Research
Health Services
Infectious Diseases
Behavioral and Social Science
Drug Abuse (NIDA only)
Health and social care services research
8.1 Organisation and delivery of services
Good Health and Well Being
Adult
Anti-Retroviral Agents
Appointments and Schedules
Choice Behavior
Delivery of Health Care
Female
HIV Infections
Humans
Male
Patient Preference
Patient-Centered Care
Physician-Patient Relations
Preference
Discrete choice experiment
Review
HIV
Service delivery
Differentiated care
Medical Microbiology
Virology
Clinical sciences
Language
Abstract
Purpose of reviewAligning HIV treatment services with patient preferences can promote long-term engagement. A rising number of studies solicit such preferences using discrete choice experiments, but have not been systematically reviewed to seek generalizable insights. Using a systematic search, we identified eleven choice experiments evaluating preferences for HIV treatment services published between 2004 and 2020.Recent findingsAcross settings, the strongest preference was for nice, patient-centered providers, for which participants were willing to trade considerable amounts of time, money, and travel distance. In low- and middle-income countries, participants also preferred collecting antiretroviral therapy (ART) less frequently than 1 monthly, but showed no strong preference for 3-compared with 6-month refill frequency. Facility waiting times and travel distances were also important but were frequently outranked by stronger preferences. Health facility-based services were preferred to community- or home-based services, but this preference varied by setting. In high-income countries, the availability of unscheduled appointments was highly valued. Stigma was rarely explored and costs were a ubiquitous driver of preferences. While present improvement efforts have focused on designs to enhance access (reduced waiting time, travel distance, and ART refill frequency), few initiatives focus on the patient-provider interaction, which represents a promising critical area for inquiry and investment. If HIV programs hope to truly deliver patient-centered care, they will need to incorporate patient preferences into service delivery strategies. Discrete choice experiments can not only inform such strategies but also contribute to prioritization efforts for policy-making decisions.