Exploring Relative Preferences for HIV Service Features Using Discrete Choice Experiments: a Synthetic Review.

Area of Science:

• Public Health
• Health Services Research
• Behavioral Science

Background:

• Aligning HIV treatment services with patient preferences is crucial for long-term engagement and adherence.
• Discrete choice experiments (DCEs) are increasingly used to understand patient preferences for HIV services.
• A systematic review of DCEs was needed to identify generalizable insights into patient preferences for HIV treatment.

Purpose of the Study:

• To systematically review discrete choice experiments evaluating patient preferences for HIV treatment services.
• To identify key factors influencing patient choices in HIV care delivery.
• To inform the development of patient-centered HIV treatment strategies.

Main Methods:

• Systematic literature search for discrete choice experiments on HIV treatment preferences.
• Inclusion of studies published between 2004 and 2020.
• Analysis of identified studies to synthesize patient preferences across different settings.

Main Results:

• Patient-centered providers were the strongest preference, valued over time, cost, and travel.
• In low- and middle-income countries, less frequent antiretroviral therapy (ART) collection was preferred.
• Health facility-based services were generally preferred, though this varied by setting; unscheduled appointments were highly valued in high-income countries.

Conclusions:

• Patient preferences, particularly for provider interaction, are critical for patient-centered HIV care.
• Current service improvements often focus on access (e.g., waiting times, travel), but the patient-provider relationship is a key area for investment.
• Incorporating patient preferences into HIV service delivery and policy-making is essential for effective engagement and treatment adherence.