Heterogeneity in preferences for HIV prevention service delivery among women of reproductive age in western Kenya: a latent class analysis

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Introduction Pharmacies might create opportunities for pregnant women to initiate HIV prevention services earlier and more regularly, but their role in HIV prevention during pregnancy—a high-risk period for HIV acquisition—remains relatively unexplored. We evaluated whether women of childbearing age have different preferences for accessing HIV prevention services in Western Kenya. Methods We administered a discrete choice experiment (DCE) survey to women aged 15–44 in Western Kenya from June to November 2023. The survey asked women to choose among HIV prevention services described by seven attributes: service location, travel time, type of HIV test, sexually transmitted infection (STI) testing, partner HIV testing, pre-exposure prophylaxis (PrEP), and service fee. We used a latent-class model with effects-coded attribute levels to explore preference heterogeneity. Results Among the 599 women included in the final analysis, the median age was 23 years (IQR: 18–27). 213 (33%) were married or living with a partner, and 311 (52%) had a prior pregnancy. The latent class analysis identified four distinct groups: the clinic-seeking group ( n = 108, 18.0%), the all-about-PrEP group ( n = 187, 31.2%), the all-about-STI testing group ( n = 224, 37.4%), and the price-sensitive group ( n = 80, 13.4%). Conclusions Women in this study exhibited heterogeneous preferences for accessing HIV prevention services. Future service design goals might prioritize STI testing and PrEP implementation, ensure targeted improvements to clinic-based services for women who value this setting, and offer flexible pricing to accommodate price-sensitive individuals.

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