Humphrey, JohnWanjama, EstherCarlucci, James G.Naanyu, VioletWere, EdwinMuli, LindahAlera, MarshaMcGuire, AlanNyandiko, WinstoneSongok, JuliaWools-Kaloustian, KaraZimet, Gregory2024-04-102024-04-102023Humphrey J, Wanjama E, Carlucci JG, et al. Preferences of Pregnant and Postpartum Women for Differentiated Service Delivery in Kenya. J Acquir Immune Defic Syndr. 2023;94(5):429-436. doi:10.1097/QAI.0000000000003303https://hdl.handle.net/1805/39864Background: Differentiated service delivery models are implemented by HIV care programs globally, but models for pregnant and postpartum women living with HIV (PPWH) are lacking. We conducted a discrete choice experiment to determine women's preferences for differentiated service delivery. Setting: Five public health facilities in western Kenya. Methods: PPWH were enrolled from April to December 2022 and asked to choose between pairs of hypothetical clinics that differed across 5 attributes: clinic visit frequency during pregnancy (monthly vs. every 2 months), postpartum visit frequency (monthly vs. only with routine infant immunizations), seeing a mentor mother (each visit vs. as needed), seeing a clinician (each visit vs. as needed), and basic consultation cost (0, 50, or 100 Kenya Shillings [KSh]). We used multinomial logit modeling to determine the relative effects (β) of each attribute on clinic choice. Results: Among 250 PPWH (median age 31 years, 42% pregnant, 58% postpartum, 20% with a gap in care), preferences were for pregnancy visits every 2 months (β = 0.15), postpartum visits with infant immunizations (β = 0.36), seeing a mentor mother and clinician each visit (β = 0.05 and 0.08, respectively), and 0 KSh cost (β = 0.39). Preferences were similar when stratified by age, pregnancy, and retention status. At the same cost, predicted market choice for a clinic model with fewer pregnant/postpartum visits was 75% versus 25% for the standard of care (ie, monthly visits during pregnancy/postpartum). Conclusion: PPWH prefer fewer clinic visits than currently provided within the standard of care in Kenya, supporting the need for implementation of differentiated service delivery for this population.en-USAttribution-NonCommercial-NoDerivatives 4.0 InternationalDifferentiated careVertical transmissionPrevention of mother-to-child transmissionKenyaPostpartumPatient-centeredArticle