Using Choice Experiments to Improve Equity in Access to Socially Marketed HIV Prevention Products

Fern Terris‐Prestholt, Abay Mulatu, Matthew Quaife, Mitzy Gafos, Graham F. Medley, Catherine MacPhai, Kara Hanson

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
36 Downloads (Pure)


Designing strategies to introduce new HIV prevention technologies requires balancing equitable access with sustainable distribution, particularly in resource constrained settings with high HIV prevalence. This paper explores how knowledge of preference heterogeneity can guide the equitable targeting of HIV prevention products using differentiated advertising and product placement to balance increased access with sustainability. A discrete choice experiment elicited 1016 women's preferences for distribution of HIV prevention products in South Africa. Qualitative research guided the experimental design which considered distribution outlet, collection method, advertising message, and price. A range of choice models, including random parameters logit, latent class and latent class random parameters logit models, were compared for fit. A latent class model showed the best fit and distinguished two classes of women: Class 1 were significantly more likely to be cohabiting and unemployed, who preferred products advertised for HIV prevention distributed through clinics and were highly price sensitive. Class 2 significantly preferred distribution through pharmacies and advertising around women's empowerment, while price was not a key factor. This analysis suggests that equity in access to new products could be advanced through exploiting preference heterogeneity between groups. The identified groups can be then used to design social marketing differentiated distribution strategies. Distributing free products promoted for HIV prevention could discourage ‘leakage’ of highly subsidised products to women with some capacity to pay, while priced products marketed for women's empowerment through pharmacies could encourage cost recovery with minimal reductions in coverage among employed women.

Original languageEnglish
Article number100319
Number of pages10
JournalJournal of Choice Modelling
Early online date27 Aug 2021
Publication statusPublished - Dec 2021

Bibliographical note

This is an open access article under the CC BY license.


The collection of the data used in this study was funded by the Microbicide Development Programme (MDP) . MDP was a partnership of African UK and Spanish academic/government institutions and commercial organisations. MDP was funded by the British Department for International Development (DfID) and the UK Medical Research Council . The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


  • Discrete choice experiments
  • Equity
  • Latent class analysis
  • Social marketing
  • South Africa

ASJC Scopus subject areas

  • Modelling and Simulation
  • Statistics, Probability and Uncertainty


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