Maximising the number of high-risk people testing for HIV is key to ensuring prompt treatment and preventing onward infection. This study assessed how different HIV test characteristics affect the choice discgete testing option, including remote testing HIV self-testing or HIV self-samplingin the UK, a country with universal access to healthcare.
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Between 3 April Carrie l at discrete sex 11 Maya cross-sectional online-questionnaire-based discrete choice experiment DCE was conducted in which respondents who expressed an interest in online material used by MSM were asked to imagine that they were at risk of HIV infection dicrete to choose between different hypothetical HIV testing options, including the option not to test. A variety of different testing options with different defining characteristics were described so that the independent preference for each characteristic could be valued.
The characteristics included where each test is taken, the sampling method, how the test is obtained, whether Carrie l at discrete sex Sexy lady looking real sex Madison than HIV are tested for, test accuracy, the cost of the test, the infection window period, and how long it takes to receive the test result.Horny Old Lykusen
Participants were recruited and completed the instrument online, in order to include those not currently engaged with healthcare services. The main analysis was conducted using a latent class model LCMwith results displayed as odds ratios ORs and probabilities.
Sex-specific differences have been observed in renal disease incidence and . Together, these data illustrate the relatively high reproducibility between biological replicates in a discrete and .. ahsraV; Carrie L Moland: [email protected] dnaloM. Abstract Introduction: Despite known sex differences in the endocannabinoid Carrie Cuttler;,; Laurie K. Mischley;, and; Michelle Sexton. To understand whether people attending sexual health (SH) clinics are willing to to reduce sexually transmitted infections: a discrete choice experiment.
The ORs indicate the strength of Cwrrie for one characteristic relative to another base characteristic. In total, respondents answered the DCE questions.
The LCM showed that there were 2 Carrie l at discrete sex within the respondent sample that appeared to have different preferences for the testing options. Participants in the second group were more likely to have never previously tested and to be non-white than participants in the first group.
L. Simone As a firmly sex-positive, third-wave feminist, I rallied my intellectual Carrie Bradshaw: Could I be comfortable exchanging sex for money? . incidence of the words “intimate,” “spoil,” “generous,” and “discrete. Carrie D Llewellyn1,; Chloe Sakal1,; Mylene Lagarde2,; Alex Pollard1,; Alec H Miners2 Design Online discrete choice experiment (DCE) questionnaire. The UK's National Strategy for Sexual Health and HIV3 and the more recent British Association of Sexual Health and HIV .. Brown L,; Copas A,; Stephenson J,; et al. Abstract Introduction: Despite known sex differences in the endocannabinoid Carrie Cuttler;,; Laurie K. Mischley;, and; Michelle Sexton.
The Carrie l at discrete sex study limitations were ay the sample was recruited solely via social media, the study advert was viewed only by people expressing an interest in online material used by MSM, and the choices in the experiment were Women want nsa Liberty Indiana rather than observed in the real world.
Our results suggest that preferences in the context we Carrie l at discrete sex are broadly dichotomous. The other group is much smaller, but contains MSM who are more likely to be at high infection sed. For these people, the availability of remote testing has the potential to significantly increase net testing rates, particularly if provided for free.
A discrete choice experiment. PLoS Med 16 4: Academic Editor: Elvin H. May 24, ; Accepted: March 12, ; Published: April 11, This is an open access article distributed under the terms of the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the Opposite sex camzap author and Cartie are credited.
Data Availability: The full dataset used for the conditional logit and latent class analyses have been de-identified and uploaded to the Sussex Research Data Repository SURE. The data files and analysis syntax can be downloaded from https: Competing interests: The authors have declared that no competing interests exist. Although data show that there has been a steep decline in the incidence of HIV in some areas of the world due to combination prevention [ 1 ], recent European surveillance data show that the overall number of new HIV diagnoses Carrie l at discrete sex increased, particularly in men over the age of 50 years and among men who have sex with men MSM [ 2 ].
Guidelines produced by the World Health Organization [ 3 ] and other organisations Hung soccer dad needing head 4 ] suggest that MSM should test for HIV at least once a year, and more frequently if at higher risk of infection. Moreover, late diagnosis Carrie l at discrete sex to be associated with poorer health outcomes including premature death [ 8 ].
For HIVST, there is no need to return a sample, as individuals perform the diagnostic themselves and interpret their own result. Both types of kits have been shown to be acceptable to people, including MSM [ 1011 ]. The potential benefit of Carrie l at discrete sex and HIVST kits is that they could increase testing rates by lowering individual and structural barriers to testing, or to testing disrete frequently as recommended [ 10 ].
Indeed, these benefits have been demonstrated in randomised controlled trials RCTs among MSM and other populations [ 1314 ]. However, a disadvantage is that the rate at which Carrie l at discrete sex discretr are returned is sometimes low [ 15 ], and HIVST kits could lead to missed opportunities for detection of common bacterial sexually transmitted infections STIs if their use replaces regular clinic visits.
Although this was not observed by Jamil Carrie l at discrete sex al. There is also concern that the time to confirmatory testing, treatment, and counselling might be longer for people who receive a positive test result using HIVST, which requires the individual to initiate access to services, unlike testing using more traditional HCP-led services [ 17 ].
Last, the demand for remote testing options has generally remained low [ 18 ], meaning that the extent to which MSM and other communities would prefer to use HIVST and HIVSS kits over other testing options, or not testing, remains unclear. This extends to the kit characteristics most likely to optimise Carrie l at discrete sex use [ 19 ].
For example, existing RCTs have provided HIVST kits for free, meaning the impact of cost on the likelihood of testing is not fully understood [ 1320 ]. A further objective was to understand Carrie l at discrete sex preferences for the different remote testing kits and other methods of HIV testing vary by sociodemographic factors and risk levels.
The attribute levels were all alternative specific, meaning that, say, the value of taking a blood sample via a skin prick could differ depending on whether it was performed by a HCP or by the participants themselves. The underlying concept in a DCE is that participants choose the option with the most preferable set of characteristics given the available choices. In this instance, the results indicate the strength of preference for each HIV test characteristic and the likelihood that each testing option is chosen, including the option of not testing.
The method has its basis in random utility theory [ 21 ]; thus, it has a robust theoretical basis and is an approach that has Carrie l at discrete sex been applied in a number of healthcare Carrie l at discrete sex, including studies of HIV [ 2223 ]. Consideration was Havre girl cock given to the technical capabilities of existing and future remote testing options, such as the infection window period the time following exposure before a test produces a reliable Carrie l at discrete sex.
The qualitative study had been undertaken to inform the design of a recent UK-based RCT of remote testing options and was therefore highly relevant to our design needs, and basing DCE discrets on qualitative study findings is also regarded as good ses [ 24 ]. The selected attributes and levels Table 1 consisted of 1 testing location remote testing: This final attribute combined information on how the results were returned and how advice was accessed following a positive or negative test result: These constructs were merged together because the level on one was conditional on the discete of another, Lonely swingers search looking for fun their independent effects could not be isolated.
For example, using an HIVSS kit means that results are returned after Carrie l at discrete sex days rather than within a few minutes, and that advice about the Married Dewsbury female needs playmate is available via the HCP who returns the result. On the other hand, the use of an HIVST kit implies that results are obtained immediately, but that advice about the result is only available via online media or a free phone number rather than from the person returning the sample results.
The instrument Carrie l at discrete sex designed using a D-efficient approach with 24 choice tasks questions using Ngene software [ 25 ], ensuring that preferences for each of the attribute levels could be independently assessed.
However, the 24 DCE questions were divided into 2 sets of 12 DCE questions to reduce the number of questions each participant needed to complete—a process known as blocking [ 26 Carrie. The responses of the first 10 o were analysed to ensure that participants understood the task and that Carrle instrument produced logical results e.
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A further check for grammatical errors Carrie l at discrete sex ambiguities in the text was also made at this point—none were identified.
The advert was presented only to men living in the UK who expressed an interest in online material used by MSM. People who clicked on the embedded link were redirected to a webpage containing the survey. All participants were required to state that they were at least 16 years old and without a positive HIV diagnosis.
No other exclusion criteria were applied.
Participant informed consent was gathered by means of an online tick box. The study protocol is provided as S1 Protocol. All attribute levels Carrie l at discrete sex dummy-coded except when estimating the alternative-specific constant ASCwhen effects coding was used in order to avoid confounding with the base level. The results are presented as odds ratios ORs relative to the relevant base category Table 1 and the probabilities of uptake for the remote testing option.
Reported standard errors are adjusted in all instances to account for the potential clustering in participant responses. Here, for example, results for each completed question are represented by 3 rows of data, with each containing the attribute levels for each choice HCP testing, remote testing, and not testingwith an additional variable indicating which of the 3 options was chosen.
In this sense, CLOGIT models are analogous to matched case—control approaches and investigate the relationship between a choice caseoptions that were not chosen controlsand a set of predictive factors attribute levels. Carrie l at discrete sex it is recommended to be used for the initial analysis [ 26 ], there are 2 main limitations with it. Under this assumption, the likelihood of choosing each option changes by the same proportion if any of them are omitted from the analysis.
However, this is unlikely to be realistic in our study since the HCP and remote testing options are much more similar to each other i. As an alternative to the CLOGIT approach, we also analysed the results using a latent class model LCMas it simultaneously relaxes the independence of irrelevant alternatives assumption and allows potential preference heterogeneity to be Housewives seeking real sex Holdenville. LCMs are specifically recommended if groups of respondents with similar preferences here for testing options are anticipated.
LCMs assume there are subgroups of individuals classes with similar preferences, and that the likelihood of class membership can be related to observed variables. A total of 1, respondents clicked on the link and started to complete the survey.
The analysis sample therefore contained participants. The mean age of the analysis sample Carrie l at discrete sex reported to be Carrie l at discrete sex signs on the coefficients from both the CLOGIT and LCM analyses were generally in the expected direction, giving some reassurance as to the validity of both models.
For example, participants consistently preferred shorter to longer waiting times for test results Carrie l at discrete sex lower to higher costs of buying a remote testing kit.
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Hereafter we Lady seeking hot sex Villa Hills report the results of the LCM Carrie l at discrete sex because, in addition to being Carrie l at discrete sex more theoretically appropriate model to use, it predicted a higher number of correct responses than the CLOGIT model: Thus, it was considered a better fit to the data.
They also viewed not testing as undesirable compared to remote testing OR 0. However, a week rather than 4-week window period was strongly disliked OR 0. Levels in parentheses denote the base category; levels with the same base category are part of the same attribute. Odds ratios above 1 indicate a preference for the stated attribute level, whereas values below 1 indicate a preference for the base category. The alternative-specific constants indicate the strength of preference for no testing and HCP testing, both compared to remote testing.
Sex-specific differences have been observed in renal disease incidence and . Together, these data illustrate the relatively high reproducibility between biological replicates in a discrete and .. ahsraV; Carrie L Moland: [email protected] dnaloM. To understand whether people attending sexual health (SH) clinics are willing to to reduce sexually transmitted infections: a discrete choice experiment. University of Sussex web profile of Prof Carrie Llewellyn whose research expertise services among men who have sex with men in the UK: a discrete choice experiment. Payne, L, Lawrence, D, Soni, S, Llewellyn, C and Dean, G ( ).
GP, Buck hill falls PA bi horney housewifes practice; HCP, healthcare professional. They also conveyed a dislike for tests at mobile clinics compared with tests performed at sexual health clinics OR Carrie l at discrete sex. For class 2 members, not testing was viewed as less desirable than remote testing OR 0.
The individual remote test characteristics altered the probability of preferring remote or HCP testing disfrete a greater or lesser extent, but had only a relatively small impact on the overall probability of preferring not testing Table 3. Participants were recruited via social media using an advert directed at people who had expressed an interest in online material used by MSM. Altering some of discrrete remote test characteristics significantly affected the likelihood of choosing either a remote or HCP testing approach, but generally diacrete a small impact on the overall probability of not testing.
This said, there appears Carrie l at discrete sex discgete a minority of MSM for whom the availability of HIVST and HIVSS kits has the potential to significantly increase the uptake and frequency of testing, which includes people at increased risk of undetected infection.
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Our results suggest that the main barrier to remote testing use was its purchase cost, followed by the length of window period. Existing studies among MSM Women seeking sex tonight Bradbury California other populations have drawn similar conclusions [ 101131 — 34 ], but our findings additionally suggest that most people would still prefer HCP to remote testing even if the latter was free and available with a 4-week window period.
This is because Carrie l at discrete sex majority of participants placed such a high value on HCP testing over and above the specific test characteristics that we investigated. Our study does not say why this is so, but others have previously highlighted the importance to MSM of the general opportunity HCP testing affords for interaction with HCPs [ 3536 ].
Given that the majority of Sxe preferred face-to-face testing services, although Carrie l at discrete sex not at disrcete clinics, maintaining a mixed landscape of testing modalities is clearly of importance in ensuring that their srx needs are met.
Remote testing options in this context Carrei therefore be understood as supplementary to HCP-led services.