Journal Article

Latent class analysis of acceptability and willingness to pay for self‐HIV testing in a United States urban neighbourhood with high rates of HIV infection

Santamaria, Karina, Mayer, Kenneth, Brinkley‐Rubinstein, Lauren, Nunn, Amy, Trooskin, Stacey, Harvey, Julia, Sabatino, Kelly, Rose, Jennifer, Chan, Philip A., Stopka, Thomas, Towey, Caitlin

2017

Overview

Introduction: Acceptability and willingness to both take and pay for HIV self‐tests (HIVSTs) in US neighbourhoods with high rates of HIV infection are not well understood. Methods: We surveyed 1,535 individuals about acceptability and willingness to take and pay for an HIVST in a predominately African American neighbourhood with 3% HIV seroprevalence. We recruited individuals presenting for HIV screening services in a community‐based programme. Latent class analysis (LCA) grouped individuals with similar patterns of HIV‐risk behaviours and determined which groups would be most willing to use and buy HIVSTs. Results: Nearly 90% of respondents were willing to use an HIVST; 55% were willing to buy HIVSTs, but only 23% were willing to pay the market price of US$40. Four distinct groups emerged and were characterized by risk behaviours: (1) low risk (N = 324); (2) concurrent partnerships (N = 346); (3) incarceration and substance use (N = 293); and (4) condomless sex/multiple partners (N = 538). Individuals in the low‐risk class were less willing to self‐test compared to concurrent sexual partners (OR = 0.39, p = .003) and incarceration and substance use (OR = 0.46, p = .011) classes. There were no significant differences across classes in the amount individuals were willing to pay for an HIVST. Conclusions: HIVSTs were overwhelmingly acceptable but cost prohibitive; most participants were unwilling to pay the market rate of US $ 40. Subsidizing and implementing HIVST programmes in communities with high rates of infection present a public health opportunity, particularly among individuals reporting condomless sex with multiple partners, concurrent sexual partnerships and those with incarceration and substance use histories.

• Publisher: International AIDS Society,John Wiley & Sons, Inc,Taylor & Francis
• Subject: Acquired immune deficiency syndrome / Adolescent / Adult / African Americans / AIDS / AIDS Serodiagnosis - economics / AIDS Serodiagnosis - methods / Analysis / Care and treatment / Cities / Data Collection / Disease control / FDA approval / Female / geography / Health aspects / Hispanic Americans / HIV / HIV infections / HIV Infections - diagnosis / HIV Infections - epidemiology / HIV self‐test / HIV tests / home‐based testing / Human immunodeficiency virus / Humans / Imprisonment / Indigent care / Infections / Latent class analysis / Male / Medical tests / neighbourhood / Patient outcomes / Primary care / Public health / Risk Factors / Risk taking / Self Care - economics / Self Care - methods / Serologic Tests - economics / Sexually transmitted diseases / STD / Studies / Substance abuse / Substance use / Surveys / Underserved populations / United States - epidemiology / Willingness to pay