Patient preferences for HIV service delivery models: A discrete choice experiment in Kisumu, Kenya

Background: Novel “differentiated service delivery” models for HIV treatment that reduce clinic visit frequency, minimize waiting time, and deliver treatment in the community promise retention improvement for HIV treatment in Sub-Saharan Africa.  Quantitative assessments of differentiated service delivery (DSD) feature most preferred by patient populations do not widely exist but could inform the selection and prioritization of different types of DSD models.
Methods: We used a discrete choice experiment (DCE) to elicit patient preferences for HIV treatment services and how they differ across DSD models. We surveyed adults aged >18 years, enrolled in HIV care for >6 months between February and March 2019 at four facilities in Kisumu County, Kenya.  DCE offered patients a series of comparisons between three treatment models, each of which varied in seven attributes: ART refill location, the quantity of ART dispensed at each refill, medication pick-up hours, type of adherence support...