Preferences for Pre-exposure Prophylaxis Service Delivery Among Female Sex Workers in Malawi: A Discrete Choice Experiment.
Kathryn Elizabeth LancasterThandie LunguAgatha BulaJaclyn M SheaAbigail ShobenMina C HosseinipourRacquel E KohlerIrving F HoffmanVivian F GoCarol E GolinStephanie B WheelerWilliam C MillerPublished in: AIDS and behavior (2020)
Female sex workers (FSW) in Malawi have among the highest HIV prevalence estimates worldwide. Daily oral pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, yet preferences for PrEP delivery among FSW are lacking. Eight focus group discussions, a literature review, and cognitive interviews were conducted to identify modifiable PrEP delivery attributes and inform discrete-choice experiment (DCE) development for FSW in Lilongwe. Enrolled FSW received an interviewer-assisted DCE. Data were analyzed using mixed logit regression. Dispensing location was most preferred, followed by the provision of additional services. Women preferred receiving PrEP at family planning clinics or non-governmental organization run drop-in centers. Cervical cancer screening was the most preferred additional service, while pregnancy testing and partner risk reduction counseling were less valued. This study was the first study to examine PrEP delivery preferences in Malawi using DCE-a powerful elicitation tool to apply to other key populations at risk for HIV.
Keyphrases
- men who have sex with men
- hiv testing
- hiv positive
- healthcare
- mental health
- cervical cancer screening
- antiretroviral therapy
- primary care
- decision making
- hiv infected
- human immunodeficiency virus
- contrast enhanced
- risk factors
- palliative care
- magnetic resonance imaging
- hiv aids
- magnetic resonance
- type diabetes
- preterm birth
- machine learning
- case report
- pregnancy outcomes
- skeletal muscle
- south africa
- insulin resistance
- deep learning