Browsing by Author "Arije O"

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    Preferences for pre-exposure prophylaxis delivery among HIV-negative pregnant and breastfeeding women in Zambia: evidence from a discrete choice experiment.
    (2024) Hamoonga TE; Mutale W; Igumbor J; Bosomprah S; Arije O; Chi BH; Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana.; Department of Health Systems Management and Policy, School of Public Health, University of Zambia, Lusaka, Zambia.; Department of Population Studies and Global Health, School of Public Health, University of Zambia, Lusaka, Zambia.; Department of Public Health, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Research Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.; Institute of Public Health, Obafemi Awolowo University, Ile-Ife, Nigeria.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    INTRODUCTION: Pregnant and breastfeeding women at substantial risk for HIV infection in sub-Saharan Africa can benefit from biomedical interventions such as pre-exposure prophylaxis (PrEP). We estimated the benefit that pregnant and breastfeeding women may derive from PrEP service delivery in order to guide PrEP roll-out in the target population in Zambia. METHODS: Between September and December 2021, we conducted a discrete choice experiment (DCE) among a convenient sample of 389 pregnant and breastfeeding women not living with HIV in Lusaka, Zambia. Women aged 18 years or older, with a documented negative HIV result in their antenatal card responded to a structured questionnaire containing 12 choice sets on service delivery attributes of PrEP: waiting time at the facility, travel time to the facility dispensing PrEP, location for PrEP pick-up, health care provider attitude and PrEP supply at each refill. Mixed logit regression analysis was used to determine the participant's willingness to trade off one attribute of PrEP for the other at a 5% significance level. Willingness to wait (WTW) was used to determine the relative utility derived from each attribute against waiting time. RESULTS: Waiting time at the facility, travel time to the facility, health care provider attitude and amount of PrEP supply at each refill were important attributes of PrEP service delivery (all CONCLUSION: Patient-centered approaches can help to inform the design and implementation of PrEP services among pregnant and breastfeeding women. In this study, we found that a reduction in clinic visits-including through multi-month dispensing of PrEP-could improve uptake of services in antenatal and postnatal settings.