Criteria for prioritization of HIV programs in Viet Nam: a discrete choice experiment

Abstract

BackgroundWith the decline in funding for Viet Nam’s response to the HIV epidemic, there is a need for evidence on the criteria to guide the prioritization of HIV programs. There is a gap in the research on the relative importance of multiple criteria for prioritizing a package of interventions. This study elicits preferences and the trade-offs made between different HIV programs by relevant stakeholders and decision-makers in Viet Nam. It also pays attention to how differences in social and professional characteristics of stakeholders and their agency affiliations shape preferences for HIV program criteria in Viet Nam.MethodsThis study uses self-explicated ranking and discrete choice experiments to determine the relative importance of five criteria - effectiveness, feasibility, cost-effectiveness, rate of investment and prevention/treatment investment ratio - to stakeholders when they evaluate and select hypothetical HIV programs. The study includes 69 participants from government, civil society, and international development partners.ResultsResults of the discrete choice experiment show that overall the feasibility criterion is ranked highest in importance to the participants when choosing a hypothetical HIV program, followed by sustainability, treatment to prevention spending ratio, and effectiveness. The participant’s work in management, programming, or decision-making has a significant effect on the importance of some criteria to the participant. In the self-explicated ranking effectiveness is the most important criterion and the cost-effectiveness criterion ranks low in importance across all groups.ConclusionsThis study has shown that the preferred HIV program in Viet Nam is feasible, front-loaded for sustainability, has a higher proportion of investment on prevention, saves more lives and prevents more infections. Similarities in government and civil society rankings of criteria can create common grounds for future policy dialogues between stakeholders. Innovative models of planning should be utilized to allow inputs of informed stakeholders at relevant stages of the HIV program planning process.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2679-0) contains supplementary material, which is available to authorized users.

A discrete choice experiment to assess patients’ preferences for HIV treatment in the urban population in Colombia

“…First, to examine which attributes were used in previous DCEs on patients' preferences in HIV treatment, a literature review was conducted in PubMed [11][12][13][14][15][16][17] . This was aided by a previous best-worst scaling study 18 , which identified the most important treatment characteristics of HIV patients in Colombia.…”

“…those patients prefer a large positive effect on life expectancy, and low levels of side effects). These expectations were based on intuitive assumptions and existing studies [11][12][13][14][15][16][17] .…”

Stated-preference research in HIV: A scoping review

“…In the United Kingdom, preferences for shorter appointment waiting times, longer opening hours, and the type of HIV care provider (general practitioner vs HIV clinic) were prioritized [14], while flexible medical and psychosocial support were priority features according to policy makers and PLWH in Thailand [70]. Three studies specifically assessed preferences of policy makers regarding HIV program design, identifying preference for prevention interventions [74] among high-risk groups [70] and compared to other non-HIV related public health interventions [69].…”

Development of a composite indicator to prioritize districts for implementation of human immunodeficiency virus programmes in Maharashtra, India

“…17 Multiple indicators have been used to prioritize HIV services; these include burden of the disease, coverage and cost of services. [18][19][20][21] Chavan and colleagues used seven indicators (Total PLHIV, ICTC HIV%, PPTCT HIV%, key population estimates in recent mapping and 2009 estimates for FSWs and MSM) to prioritize districts in Gujarat. 22 Though this was a useful exercise, the parameters were restricted to the existing burden of disease and estimates of key population.…”