Predicted choice and acceptability of regimens for tuberculosis preventive treatment among people living with HIV in Uganda – A discrete choice experiment
9 affiliations
- 1Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, United States of America
- 2Center for Tuberculosis, University of California San Francisco, San Francisco, California, United States of America
- 3Infectious Diseases Research Collaboration, Kampala, Uganda
- 4Uganda Tuberculosis Implementation Research Consortium, Walimu, Kampala, Uganda
- 5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- 6Division of Pulmonary Diseases and Critical Care Medicine, University of California Irvine, Irvine, California, United States of America
- 7Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- 8Makerere University Joint AIDS Program, Kampala, Uganda
- 9Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
Abstract
Little is known about people living with HIV’s preferences for different tuberculosis preventive treatment (TPT) regimens, or the conditions under which they would accept treatment. Actionable evidence regarding preference for TPT is needed to inform policy and the development of novel TPT regimens. Adults engaged in care at an HIV clinic in Kampala, Uganda, completed a discrete choice experiment survey with nine random choice tasks. In each task, participants first chose between two hypothetical TPT regimens with differing treatment features (number of pills, frequency, duration, adjusted antiretroviral dosage, and side effects). Second, they answered if they would accept the selected treatment, versus taking no treatment. We simulated predicted TPT regimen choice based on hierarchical Bayesian estimation of individual preference weights. Among 400 participants, 394 gave high-quality answers and were included (median age 44, 71.8% female, 91.4% previously received TPT). Across nine tasks, 60.2% (237/394) accepted all selected TPT regimens, 39.3% (155/394) accepted some regimens, and 0.5% (2/394) accepted none. Choice simulations showed that if only 6 months of daily isoniazid (6H) was available, 11.9% of participants were predicted to prefer no TPT. However, offering a 4-pill, fixed-dose combination 3HP regimen in addition to 6H increased the acceptability from 88.1% to 98.8% (predicted choice of 3HP 94.5%, 6H 4.4%, no TPT 1.2%). Choice simulations showed that 10 pills per dose and antiretroviral dosage adjustment had the largest effects on reducing the acceptability of regimens. While adults living with HIV in Uganda demonstrate a high willingness to accept different TPT regimens, offering regimens with preferred features, such as 3HP as a fixed-dose combination, could drive TPT acceptance and uptake from high to nearly universal.
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BibTeX
@article{aschmann2026predicted,
title = {{Predicted choice and acceptability of regimens for tuberculosis preventive treatment among people living with HIV in Uganda – A discrete choice experiment}},
author = {Hélène E. Aschmann and Allan Musinguzi and Jillian L. Kadota and Catherine Namale and Juliet Kakeeto and Jane Nakimuli and Lydia Akello and Fred Welishe and Anne Nakitende and Christopher Berger and David W. Dowdy and Adithya Cattamanchi and Fred C. Semitala and Andrew D. Kerkhoff},
journal = {PLOS Global Public Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pgph.0005630},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005630},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Predicted choice and acceptability of regimens for tuberculosis preventive treatment among people living with HIV in Uganda – A discrete choice experiment
AU - Hélène E. Aschmann
AU - Allan Musinguzi
AU - Jillian L. Kadota
AU - Catherine Namale
AU - Juliet Kakeeto
AU - Jane Nakimuli
AU - Lydia Akello
AU - Fred Welishe
AU - Anne Nakitende
AU - Christopher Berger
AU - David W. Dowdy
AU - Adithya Cattamanchi
AU - Fred C. Semitala
AU - Andrew D. Kerkhoff
PY - 2026
DA - 2026/09/10
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0005630
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005630
AB - Little is known about people living with HIV’s preferences for different tuberculosis preventive treatment (TPT) regimens, or the conditions under which they would accept treatment. Actionable evidence regarding preference for TPT is needed to inform policy and the development of novel TPT regimens. Adults engaged in care at an HIV clinic in Kampala, Uganda, completed a discrete choice experiment survey with nine random choice tasks. In each task, participants first chose between two hypothetical TPT regimens with differing treatment features (number of pills, frequency, duration, adjusted antiretroviral dosage, and side effects). Second, they answered if they would accept the selected treatment, versus taking no treatment. We simulated predicted TPT regimen choice based on hierarchical Bayesian estimation of individual preference weights. Among 400 participants, 394 gave high-quality answers and were included (median age 44, 71.8% female, 91.4% previously received TPT). Across nine tasks, 60.2% (237/394) accepted all selected TPT regimens, 39.3% (155/394) accepted some regimens, and 0.5% (2/394) accepted none. Choice simulations showed that if only 6 months of daily isoniazid (6H) was available, 11.9% of participants were predicted to prefer no TPT. However, offering a 4-pill, fixed-dose combination 3HP regimen in addition to 6H increased the acceptability from 88.1% to 98.8% (predicted choice of 3HP 94.5%, 6H 4.4%, no TPT 1.2%). Choice simulations showed that 10 pills per dose and antiretroviral dosage adjustment had the largest effects on reducing the acceptability of regimens. While adults living with HIV in Uganda demonstrate a high willingness to accept different TPT regimens, offering regimens with preferred features, such as 3HP as a fixed-dose combination, could drive TPT acceptance and uptake from high to nearly universal.
SN - 2767-3375
ER -