Factors influencing HIV testing choices among Chinese undergraduates: insights from a discrete choice experiment

Globally, HIV infection rates continue to be a significant public health concern. In China, undergraduates are particularly vulnerable to HIV infection. Despite multiple prevention and control measures, HIV testing rates among undergraduates remain low. This study aims to elicit undergraduates' preferences for key characteristics of HIV testing options. Understanding their preference will help raise testing rates. A discrete choice experiment (DCE) was conducted among undergraduates in Wuhan, China. They were asked to make eight choices between two unlabeled alternatives that differed in five attributes (testing location, testing sample, additional services, testing cost, and minimum travel time). Data were analyzed using a mixed logit model. A total of 461 undergraduates provided valid responses for analyses. Most undergraduates were heterosexual (78.5%) and non-medical majors (81.8%). Testing location was the most important non-monetary attribute, followed by testing sample and whether additional services were offered with the test. Undergraduates preferred qualified medical institutions for HIV testing than self-testing at home (β = 1.640, P < 0.001). They favored oral fluid as a method to obtain the sample, relative to urine samples (β = 0.821, P < 0.001). Free health checks offered at HIV testing was the most significant driving factor for their choice of HIV testing services (β = 0.460, P < 0.001). Undergraduates preferred free tests (β=-0.020, P < 0.001). Additionally, gender, years at the university and sexual orientation were statistically significant in the preference choices of HIV testing services for undergraduates. Understanding undergraduates' preferences for HIV testing services is the first step in designing future HIV prevention and control policies. Testing location was the most important non-monetary attribute in HIV testing services. Qualified medical institutions could regularly train campus doctors and establish partnerships to address undergraduates' needs and promote their participation in HIV testing.