Assessing willingness to test for HIV among men who have sex with men using conjoint analysis, evidence for uptake of the FDA-approved at-home HIV test.
Men who have sex with men (MSM) in the USA, represent a vulnerable population with lower rates of HIV testing. There are various specific attributes of HIV testing that may impact willingness to test (WTT) for HIV. Identifying specific attributes influencing patients' decisions around WTT for HIV is critical to ensure improved HIV testing uptake. This study examined WTT for HIV by using conjoint analysis, an innovative method for systematically estimating consumer preferences across discrete attributes. WTT for HIV was assessed across eight hypothetical HIV testing scenarios varying across seven dichotomous attributes: location (home vs. clinic), price (free vs. 50),samplecollection(fingerprickvs.blood),timelinessofresults(immediatevs.1−2weeks),privacy(anonymousvs.confidential),resultsgiven(byphonevs.in−person),andtypeofcounseling(brochurevs.in−person).Seventy−fiveMSMwererecruitedfromacommunity−basedorganizationprovidingHIVtestingservicesinLosAngelestoparticipateinconjointanalysis.WTTforHIVscorewasbasedona100−pointscale.Scoresrangedfrom32.2to80.3foreighthypotheticalHIVtestingscenarios.PriceofHIVtesting(freevs.50) had the highest impact on WTT (impact score = 31.4, SD = 29.2, p<0.0001), followed by timeliness of results (immediate vs. 1-2 weeks) (impact score = 13.9, SD = 19.9, p≤0.0001) and testing location (home vs. clinic) (impact score = 10.3, SD = 22.8, p=0.0002). Impacts of other HIV testing attributes were not significant. Conjoint analysis method enabled direct assessment of HIV testing preferences and identified specific attributes that significantly impact WTT for HIV among MSM. This method provided empirical evidence to support the potential uptake of the newly FDA-approved over-the-counter HIV home test kit with immediate results, with cautionary note on the cost of the kit