Acceptability and Preferences of Two Different Community Models of ART Delivery in a High Prevalence Urban Setting in Zambia: Cluster-Randomized Trial, Nested in the HPTN 071 (PopART) Study

AIDS Behav. 2022 Feb;26(2):328-338. doi: 10.1007/s10461-021-03385-8. Epub 2021 Jul 24.

Abstract

Community delivery of Antiretroviral therapy (ART) is a novel innovation to increase sustainable ART coverage for People living with HIV (PLHIV) in resource limited settings. Within a nested cluster-randomised sub-study in two urban communities that participated in the HPTN 071 (PopART) trial in Zambia we investigated individual acceptability and preferences for ART delivery models. Stable PLHIV were enrolled in a cluster-randomized trial of three different models of ART: Facility-based delivery (SoC), Home-based delivery (HBD) and Adherence clubs (AC). Consenting individuals were asked to express their stated preference for ART delivery options. Those assigned to the community models of ART delivery arms could choose ("revealed preference") between the assigned arm and facility-based delivery. In total 2489 (99.6%) eligible individuals consented to the study and 95.6% chose community models of ART delivery rather than facility-based delivery when offered a choice. When asked to state their preference of model of ART delivery, 67.6% did not state a preference of one model over another, 22.8% stated a preference for HBD, 5.0% and 4.6% stated a preference for AC and SoC, respectively. Offering PLHIV choices of community models of ART delivery is feasible and acceptable with majority expressing HBD as their stated preferred option.

Keywords: Adherence clubs; Anti-retroviral therapy; HIV; Home-based ART delivery; Stated preference.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anti-HIV Agents* / therapeutic use
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Prevalence
  • Zambia / epidemiology

Substances

  • Anti-HIV Agents