Introduction Syphilis and HIV screening is highly recommended for pregnant women and those at risk for infection. Enhanced control and prevention can be accomplished through more testing. We used conjoint analysis, an innovative method for systematically estimating consumer preferences across discrete attributes, to identify factors associated with testing preferences for HIV and syphilis infection.
Methods We recruited 298 men and women 18 years and over seeking testing or care at GHESKIO (Haitian Study Group for Kaposi’s sarcoma and Opportunistic Infections) clinics. We created 8 hypothetical test profiles varying across six dichotomous attributes: cost (free vs. $4), accuracy (no false positive vs. false positive), time-to-result (20 min vs. 1 week), blood draw method (finger prick vs. venipuncture), number of draws (1 vs. 2), and test type (rapid vs. laboratory). Participants were asked to rate each profile using Likert preference scales. Ratings were converted to 100-point preference scores; higher scores suggest increased preference. An impact score was generated for each attribute by taking the difference between the preference scores for the preferred and non-preferred level of each attribute. Two-sided one-sample t-test was used to generate p-values.
Results Of 298 study participants, 61 (20.5%) were male. Of 237 females, 49 (20.7%) were pregnant. Cost (free vs. $4; impact score = 27.2, SD = 36.6, p < 0.0001) had the highest impact on likelihood of testing, followed by number of blood draws (1 vs. 2; impact score = 17.5, SD = 29.8, p < 0.0001), blood draw method (fingerprick vs. venipuncture; impact score = 9.7, SD = 26.5, p < 0.0001), test type (rapid vs. laboratory; impact score = -4.5, SD = 21.9, P = 0.0005), and time-to-result (20 min vs. 1 week; impact score = 3.6, SD = 25.6, p = 0.0139).
Conclusion HIV and syphilis testing preferences for this study sample in Port-au-Prince prioritised cost, single fingerprick and timeliness. Implementing a low cost dual rapid test in the laboratory for HIV and syphilis could improve screening uptake and accessibility to accelerate time to treatment.
Disclosure of interest statement The study was supported in part by Standard Diagnostics.