HIV Preferences in Tanzania

Having HIV testing close to one’s home makes in more likely that one will get tested. At the same time, HIV preferences vary greatly across individuals, according to new research conducted by Duke Global Health Institute faculty members. The findings could help inform how HIV-testing services are adapted and expanded across sub-Saharan Africa.

The researchers surveyed nearly 500 adults in an urban setting of Northern Tanzania and found that about half of individuals preferred testing at home. This runs counter to other studies suggesting that homebased testing is largely acceptable in similar settings. Study participants also preferred finger pricks and venipuncture tests over oral swabs. Preferred testing methods are particularly relevant, because oral test kits could soon be made available in Tanzania. Factors like on-site availability of HIV medications and the availability of testing on weekends were less important to participants.

Other promising findings reveal that adults increasingly are getting tested more than once to confirm their negative status and, in more cases, are sharing results with their partner or spouse. The study also indicates that confidentiality is less important than previously thought, possibly signaling a shift in stigma about testing. Only a third of the participants preferred to keep their HIV test confidential.

Little is known about the HIV testing preferences of adults in high-risk settings, including in sub-Saharan Africa. The Duke study is the first to use a survey tool called Discrete Choice Experiments to understand HIV testing preferences in Africa. “Understanding population preferences is a critical step for increasing the uptake of HIV testing,” says Nathan Thielman, associate professor of medicine and global health. “Because HIV treatment reduces transmission, widespread HIV testing and treatment has tremendous potential to diminish the epidemic.”