Global Stakeholder Preferences for Point-Of-Care HIV Nucleic Acid Amplification Tests: A Conjoint Study

Introduction: This study aimed to assess global stakeholder preferences for key attributes of point-of-care (POC) HIV Nucleic Acid Amplification Tests (NAAT), with the aim of informing product development to support progress toward UNAIDS 95-95-95 targets. Methods: A web-based conjoint survey was conducted in August through November 2024 among HIV clinicians, laboratory professionals, and researchers. Participants were asked to evaluate hypothetical POC HIV NAAT profiles varying by six attributes: sensitivity / limit of detection (LOD), sample- collection method, turnaround time (TAT), result format, price, and power source. Relative importance and part-worth utilities were calculated to assess trade-offs in decision-making. Results: One hundred three respondents from 33 countries, primarily in Africa (75%), completed the survey. The relative importance placed on the attributes in the conjoint task varied based on the setting. In community and home-based settings, participants prioritized fingerstick sample collection (25.90%) and faster TATs (28.8%), even at the expense of sensitivity (15.70%). By contrast, respondents from hospitals and health centers valued tests with high sensitivity (42.6%, 40.9%) and faster TATs (31.5%, 22.6%). Across all respondents, price (7.0%), result format (3.30%), and power source (7.25%) were less influential. Conclusions: Stakeholders were willing to make trade-offs among desirable attributes, prioritizing rapid turnaround time, strong sensitivity, and fingerstick sampling over affordability, power requirements, and result format in the conjoint task. These preferences vary by level of care and by use case, underscoring the importance of aligning product features with contextual needs. Engaging stakeholders early in the design process is critical to ensure new POC HIV NAAT technologies are both acceptable and scalable in low-resource settings.