Clinical trial NCT03559959: A Field Experiment to Assess the Demand for HIV Self-Tests in Zimbabwe
Official title: A Field Experiment to Assess the Demand for HIV Self-Tests in Zimbabwe
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: HIV/AIDS
Lead sponsor: University of Pennsylvania
Sponsor class: OTHER
Collaborators: name: Centre for Sexual Health and HIV/AIDS Research Zimbabwe
First posted: 2018-06-18
Enrollment: 4000
Sex: ALL
Minimum age (years): 16
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Primary purpose: SCREENING

Brief summary: This study is a field experiment in peri-urban and rural communities near Harare, Zimbabwe, that seeks to estimate the likelihood that individuals will purchase HIV self-tests under various pricing and distribution strategies. About 4,000 adults will be randomly selected, administered a short questionnaire, and given vouchers that will offer them HIV self-tests at randomly allocated prices and distribution sites. The study will also test whether the provision of HIV self-tests can be targeted more cost-effectively to reach high-risk persons and non- recent testers. Last, the study will explore whether demand for repeated HIV self-testing is contingent on the price offered initially.

Detailed description: This study is a field experiment that seeks to obtain "revealed preference" estimates of the likelihood that individuals will purchase oral fluid-based HIV self-tests at alternative prices. Such an approach is useful for estimating the price sensitivity (or elasticity) of demand for HIV self-tests. The study will also estimate the extent to which demand for self-tests differs by certain distribution channels such as retail outlets, public sector health facilities, and other community-based venues. Importantly, the experiment will also test whether the provision of HIV self-tests can be targeted more cost-effectively to reach high-risk persons and non-recent testers by examining the demand for self-tests in these populations in responses to various prices and distribution strategies. The results of the study will provide vital information required by policy makers and implementers on the optical pricing and distribution strategies for introducing HIV self-tests and scaling up HIVST in resource-limited settings. In a subsequent study with additional funding, the study will also seek to determine the long-term implications of offering self-tests at very low prices initially; specifically, it will assess whether free distribution initially suppresses individuals' willingness to pay for self-tests in the future. Roughly 12 months after the initial voucher offer, participants who provided a mobile phone number they can access within their household will be contacted via phone-based text messages and offered the same HIV self-tests again at one common non-zero price. The purchases at 12 months will once again be monitored and linked to participants via a unique identifier that is included in the text messages.

Eligibility criteria: Inclusion Criteria:

* Age 16 years or older
* Willing and able to provide written informed consent for participation
* Intends to stay in the study area for at least 12 months

Primary outcomes:
measure: Voucher redemption
timeFrame: One month after enrollment
Secondary outcomes:
measure: Voucher redemption in key populations
timeFrame: One month
Other outcomes:
Locations:
city: Harare
country: Zimbabwe
facility: Zimbabwe and the Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe
Study officials:
affiliation: University of Pennsylvania
name: Harsha Thirumurthy, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Chang W, Matambanadzo P, Takaruza A, Hatzold K, Cowan FM, Sibanda E, Thirumurthy H. Effect of Prices, Distribution Strategies, and Marketing on Demand for HIV Self-testing in Zimbabwe: A Randomized Clinical Trial. JAMA Netw Open. 2019 Aug 2;2(8):e199818. doi: 10.1001/jamanetworkopen.2019.9818.