Heterogeneity in preferences for HIV prevention service delivery among women of reproductive age in western Kenya: a latent class analysis.

INTRODUCTION

Pharmacies might create opportunities for pregnant women to initiate HIV prevention services earlier and more regularly, but their role in HIV prevention during pregnancy-a high-risk period for HIV acquisition-remains relatively unexplored. We evaluated whether women of childbearing age have different preferences for accessing HIV prevention services in Western Kenya.

METHODS

We administered a discrete choice experiment (DCE) survey to women aged 15-44 in Western Kenya from June to November 2023. The survey asked women to choose among HIV prevention services described by seven attributes: service location, travel time, type of HIV test, sexually transmitted infection (STI) testing, partner HIV testing, pre-exposure prophylaxis (PrEP), and service fee. We used a latent-class model with effects-coded attribute levels to explore preference heterogeneity.

RESULTS

Among the 599 women included in the final analysis, the median age was 23 years (IQR: 18-27). 213 (33%) were married or living with a partner, and 311 (52%) had a prior pregnancy. The latent class analysis identified four distinct groups: the clinic-seeking group (n = 108, 18.0%), the all-about-PrEP group (n = 187, 31.2%), the all-about-STI testing group (n = 224, 37.4%), and the price-sensitive group (n = 80, 13.4%).

CONCLUSIONS

Women in this study exhibited heterogeneous preferences for accessing HIV prevention services. Future service design goals might prioritize STI testing and PrEP implementation, ensure targeted improvements to clinic-based services for women who value this setting, and offer flexible pricing to accommodate price-sensitive individuals.