Preference for chlamydia testing and management in Hong Kong: A discreet choice experiment

Abstract

Background As most chlamydia cases are asymptomatic, regular screening and timely management is important for chlamydia control. We aimed to determine the preferences of people living in Hong Kong for chlamydia testing and management services. Methods An online panel (hosted by Toluna) of sexually active individuals living in Hong Kong completed an online survey with two discrete choice experiments (DCEs). The first DCE examined the preferred attributes of a chlamydia testing service (cost, location, appointment time, speed of results, delivery of results and availability of other STI testing). The second DCE examined the preferred attributes of a chlamydia management service (cost, access to patient delivered partner therapy (PDPT), location, travel time, type of person consulted, and attitude of staff). Results A representative sample of 520 individuals participated; average age was 36.8 years (SD 9.9), 40% were males and 66% had a Bachelor’s degree or higher. The choice to test was most influenced by cost (free), followed by speed of results (in 14 days), delivery of results (via SMS), extra STI testing, appointment available (same day), and the least important was location of testing (private hospital). The choice to attend for management of chlamydia was most influenced by the attitude of staff (not rude), followed by cost (free), who they consult (specialist), access to PDPT, travel time (less than 30 minutes) and the least important was treatment location (antibiotics sent to home). There was significant heterogeneity in preferences related to age, place of birth, those reporting more than one sexual partner in the preceding six months and gender. Conclusion To design effective chlamydia testing and management services, it is important to account for patient preferences. For people living in Hong Kong, cost and staff attitude were the most important factors for deciding whether to test or be managed for chlamydia, respectively.