Preferences for HIV testing among partners of transgender women in Lima, Peru: a discrete choice experiment
Deanna Tollefson, Alexander Lankowski, Sayan Dasgupta, Claudia Kazmirak, Hugo Sanchez, Ivan Gonzales, Ann DuerrBackground:
Partners of transgender women (PTW) are a relatively overlooked population despite being at disproportionately high risk for HIV in Latin America. Understanding PTW preferences for HIV testing is crucial to inform the delivery of effective HIV testing and prevention services for this population.
Setting:
Lima, Peru.
Methods:
From September to November 2023, we recruited HIV-negative PTW for a discrete choice experiment (DCE) evaluating preferences for HIV testing services. PTW were recruited via referral from transgender women. The DCE considered six attributes for HIV testing, each with two to three levels. Participants were presented a total of 12 choice tasks. We used conditional logit modeling to estimate preferences and performed latent class analysis to explore heterogeneity. Additionally, we evaluated willingness to pay for preferred HIV testing service attributes.
Results:
Overall, 292 PTW completed the DCE. Attributes with the greatest influence on HIV testing preferences were cost (50% relative attribute importance) and affiliation with an LGBTQ+ friendly clinic (36%). While participants strongly preferred free HIV testing, they were willing to pay an estimated 39 Soles (95% CI: 31–47 Soles) ($10.70 USD) for testing at LGTBQ+ affiliated clinics and 7 Soles (0.8–13 Soles) ($1.90) for testing at private clinics. Three latent classes were identified: 52% belonged to a class with null preferences, 27% to a class with strong preferences for testing at LGBTQ+ friendly clinics, and 21% with strongest preferences for free testing.
Conclusion:
PTW were most concerned about cost of HIV testing but may be willing to pay for a service offered at clinics known and trusted by the LGTBQ+ community. To enhance uptake of HIV testing in this population, programs could prioritize LGTBQ+ affiliated clinics as sites of service provision.