"I will choose when to test, where I want to test": Investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe

Pitchaya P. Indravudh; Euphemia Sibanda; Marc D'Elbée; Moses Kumwenda; Beate Ringwald; Galven Maringwa; Musonda Simwinga; Lot J. Nyirenda; Cheryl C. Johnson; Karin Hatzold; Fern Terris-Prestholt; Miriam Taegtmeyer

doi:10.1097/qad.0000000000001516

"I will choose when to test, where I want to test": Investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe

Pitchaya P. Indravudh, Euphemia Sibanda, Marc D'Elbée, Moses Kumwenda, Beate Ringwald, Galven Maringwa, Musonda Simwinga, Lot J. Nyirenda, Cheryl C. Johnson, Karin Hatzold, Fern Terris-Prestholt, Miriam Taegtmeyer

Research output: Contribution to journal › Article › peer-review

117 Citations (Scopus)

Abstract

Objectives

This study identifies young people’s preferences for HIV self-testing (HIVST) delivery, determines the relative strength of preferences and explores underlying behaviors and perceptions to inform youth-friendly services in southern Africa.

Design

A mixed methods design was adopted in Malawi and Zimbabwe and includes focus group discussions (FGD), in-depth interviews (IDI) and discrete choice experiments (DCE).

Methods

This study was conducted during the formative phase of cluster randomized trials of oral-fluid HIVST distribution. Young people aged 16-25 years were purposively selected for IDIs (n=15) in Malawi and 12 FGDs (n=107) across countries. A representative sample of young people were administered a DCE on HIVST delivery, with data analyzed to estimate relative preferences for service characteristics. The qualitative results provided additional depth and were triangulated with the quantitative findings

Results

There was strong concordance across methods and countries based on the three triangulation parameters: product, provider and service characteristics. HIVST was highly accepted by young people, if provided at no or very low cost. Young people expressed mixed views on oral-fluid tests, weighing perceived benefits with accuracy concerns. There was an expressed lack of trust in health providers and preference for lay community distributors. HIVST addressed youth-specific barriers to standard HIV testing, with home-based distribution considered convenient. Issues of autonomy, control, respect, and confidentiality emerged as key qualitative themes.

Conclusion

HIVST services can be optimized to reach young people if products are provided through home-based distribution and at low costs, with respect for them as autonomous individuals.

Original language	English
Pages (from-to)	S203-S212
Journal	AIDS
Volume	31
DOIs	https://doi.org/10.1097/qad.0000000000001516
Publication status	Published - 1 Jul 2017

Keywords

adolescents
discrete choice experiments
HIV self-testing
Malawi
preferences
young people
Zimbabwe

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/qad.0000000000001516Licence: CC BY-NC-ND

AIDS-D-17-00149 R2 (1)Accepted author manuscript, 2.59 MB
AIDS 31 S3 S203-S212 2017Final published version, 293 KBLicence: CC BY-NC-ND

Cite this

Indravudh, P. P., Sibanda, E., D'Elbée, M., Kumwenda, M., Ringwald, B., Maringwa, G., Simwinga, M., Nyirenda, L. J., Johnson, C. C., Hatzold, K., Terris-Prestholt, F., & Taegtmeyer, M. (2017). "I will choose when to test, where I want to test": Investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe. AIDS, 31, S203-S212. https://doi.org/10.1097/qad.0000000000001516

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title = "{"}I will choose when to test, where I want to test{"}: Investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe",

abstract = "Objectives This study identifies young people{\textquoteright}s preferences for HIV self-testing (HIVST) delivery, determines the relative strength of preferences and explores underlying behaviors and perceptions to inform youth-friendly services in southern Africa. Design A mixed methods design was adopted in Malawi and Zimbabwe and includes focus group discussions (FGD), in-depth interviews (IDI) and discrete choice experiments (DCE).Methods This study was conducted during the formative phase of cluster randomized trials of oral-fluid HIVST distribution. Young people aged 16-25 years were purposively selected for IDIs (n=15) in Malawi and 12 FGDs (n=107) across countries. A representative sample of young people were administered a DCE on HIVST delivery, with data analyzed to estimate relative preferences for service characteristics. The qualitative results provided additional depth and were triangulated with the quantitative findingsResults There was strong concordance across methods and countries based on the three triangulation parameters: product, provider and service characteristics. HIVST was highly accepted by young people, if provided at no or very low cost. Young people expressed mixed views on oral-fluid tests, weighing perceived benefits with accuracy concerns. There was an expressed lack of trust in health providers and preference for lay community distributors. HIVST addressed youth-specific barriers to standard HIV testing, with home-based distribution considered convenient. Issues of autonomy, control, respect, and confidentiality emerged as key qualitative themes.ConclusionHIVST services can be optimized to reach young people if products are provided through home-based distribution and at low costs, with respect for them as autonomous individuals.",

keywords = "adolescents, discrete choice experiments, HIV self-testing, Malawi, preferences, young people, Zimbabwe",

author = "Indravudh, \{Pitchaya P.\} and Euphemia Sibanda and Marc D'Elb{\'e}e and Moses Kumwenda and Beate Ringwald and Galven Maringwa and Musonda Simwinga and Nyirenda, \{Lot J.\} and Johnson, \{Cheryl C.\} and Karin Hatzold and Fern Terris-Prestholt and Miriam Taegtmeyer",

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Indravudh, PP, Sibanda, E, D'Elbée, M, Kumwenda, M , Ringwald, B , Maringwa, G, Simwinga, M, Nyirenda, LJ, Johnson, CC, Hatzold, K, Terris-Prestholt, F & Taegtmeyer, M 2017, '"I will choose when to test, where I want to test": Investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe', AIDS, vol. 31, pp. S203-S212. https://doi.org/10.1097/qad.0000000000001516

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T1 - "I will choose when to test, where I want to test": Investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe

AU - Indravudh, Pitchaya P.

AU - Sibanda, Euphemia

AU - D'Elbée, Marc

AU - Kumwenda, Moses

AU - Ringwald, Beate

AU - Maringwa, Galven

AU - Simwinga, Musonda

AU - Nyirenda, Lot J.

AU - Johnson, Cheryl C.

AU - Hatzold, Karin

AU - Terris-Prestholt, Fern

AU - Taegtmeyer, Miriam

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objectives This study identifies young people’s preferences for HIV self-testing (HIVST) delivery, determines the relative strength of preferences and explores underlying behaviors and perceptions to inform youth-friendly services in southern Africa. Design A mixed methods design was adopted in Malawi and Zimbabwe and includes focus group discussions (FGD), in-depth interviews (IDI) and discrete choice experiments (DCE).Methods This study was conducted during the formative phase of cluster randomized trials of oral-fluid HIVST distribution. Young people aged 16-25 years were purposively selected for IDIs (n=15) in Malawi and 12 FGDs (n=107) across countries. A representative sample of young people were administered a DCE on HIVST delivery, with data analyzed to estimate relative preferences for service characteristics. The qualitative results provided additional depth and were triangulated with the quantitative findingsResults There was strong concordance across methods and countries based on the three triangulation parameters: product, provider and service characteristics. HIVST was highly accepted by young people, if provided at no or very low cost. Young people expressed mixed views on oral-fluid tests, weighing perceived benefits with accuracy concerns. There was an expressed lack of trust in health providers and preference for lay community distributors. HIVST addressed youth-specific barriers to standard HIV testing, with home-based distribution considered convenient. Issues of autonomy, control, respect, and confidentiality emerged as key qualitative themes.ConclusionHIVST services can be optimized to reach young people if products are provided through home-based distribution and at low costs, with respect for them as autonomous individuals.

AB - Objectives This study identifies young people’s preferences for HIV self-testing (HIVST) delivery, determines the relative strength of preferences and explores underlying behaviors and perceptions to inform youth-friendly services in southern Africa. Design A mixed methods design was adopted in Malawi and Zimbabwe and includes focus group discussions (FGD), in-depth interviews (IDI) and discrete choice experiments (DCE).Methods This study was conducted during the formative phase of cluster randomized trials of oral-fluid HIVST distribution. Young people aged 16-25 years were purposively selected for IDIs (n=15) in Malawi and 12 FGDs (n=107) across countries. A representative sample of young people were administered a DCE on HIVST delivery, with data analyzed to estimate relative preferences for service characteristics. The qualitative results provided additional depth and were triangulated with the quantitative findingsResults There was strong concordance across methods and countries based on the three triangulation parameters: product, provider and service characteristics. HIVST was highly accepted by young people, if provided at no or very low cost. Young people expressed mixed views on oral-fluid tests, weighing perceived benefits with accuracy concerns. There was an expressed lack of trust in health providers and preference for lay community distributors. HIVST addressed youth-specific barriers to standard HIV testing, with home-based distribution considered convenient. Issues of autonomy, control, respect, and confidentiality emerged as key qualitative themes.ConclusionHIVST services can be optimized to reach young people if products are provided through home-based distribution and at low costs, with respect for them as autonomous individuals.

KW - adolescents

KW - discrete choice experiments

KW - HIV self-testing

KW - Malawi

KW - preferences

KW - young people

KW - Zimbabwe

U2 - 10.1097/qad.0000000000001516

DO - 10.1097/qad.0000000000001516

M3 - Article

SN - 0269-9370

VL - 31

SP - S203-S212

JO - AIDS

JF - AIDS

ER -

"I will choose when to test, where I want to test": Investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe

Abstract

Keywords

UN SDGs

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