---
title: "Global stakeholder priorities for point-of-care HIV NAATs: sensitivity, speed, and fingerstick sam"
id: "plos-one-11-global-stakeholder-preferences-for-point-of-care-hiv-nucleic-acid-amplification"
canonical_url: "https://medichelpline.com/clinical-feed/plos-one-11-global-stakeholder-preferences-for-point-of-care-hiv-nucleic-acid-amplification"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PLOS ONE (Medicine)"
source_url: "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0361025"
published_at: "2026-10-22T14:00:00.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Global stakeholder priorities for point-of-care HIV NAATs: sensitivity, speed, and fingerstick sam
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/plos-one-11-global-stakeholder-preferences-for-point-of-care-hiv-nucleic-acid-amplification
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PLOS ONE (Medicine)
- **Source URL:** [Original Journal Publication](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0361025)
- **Published At:** 2026-10-22T14:00:00.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- Investigators conducted a web-based conjoint survey from August 14 to November 22, 2024, asking HIV clinicians, laboratory professionals, and researchers to rate 12 hypothetical **point-of-care (POC) HIV NAAT** profiles. - The survey sampled 103 respondents across 33 countries; most respondents (74.8%) were based in Africa and completion averaged 11 minutes. - Respondents evaluated six attributes: **limit of detection (LOD)**, sample-collection method, turnaround time (TAT), result format, price, and power source; these were combined into 12 balanced profiles drawn from 144 possible combinations. - Overall, LOD (36.5% importance), TAT (28.7%), and sample-collection method (17.3%) carried the greatest weight in adoption decisions; price, result format, and power source were comparatively low influence. - Importance varied by setting: in community/home settings, faster TAT and fingerstick sampling ranked higher than sensitivity; in hospitals and health centers, high sensitivity and faster TAT dominated. - Part-worth utilities indicated the most preferred attribute levels across groups were an LOD of 200 copies/mL, fingerstick sampling, a 15-minute TAT, mains power with battery backup, quantitative results, and a lower price level—though the exact preferred price varied by subgroup. - Investigators reported a 37% response rate (278 accessed, 103 completed); recruitment relied on professional networks and snowballing, so a probability sample was not possible. - The study team noted trade-offs are inevitable: the theoretically ideal test combining high sensitivity, rapid TAT, and minimal sample volume may be technically or operationally infeasible. - Data and the full survey instrument are provided in the article’s supplemental files; funding sources included US NIH institutes, and authors declared no competing interests.
## Clinical Analysis & Structured Key Points
Global stakeholder preferences for point-of-care HIV nucleic acid amplification tests: A conjoint study | PLOS One Browse Subject Areas ? Click through the PLOS taxonomy to find articles in your field. For more information about PLOS Subject Areas, click here . Article Authors Metrics Comments Media Coverage Reader Comments Figures Figures Abstract 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. Citation: Palamountain KM, Achar C, Kirby RP, Manabe YC, Boeras D, Maimaran M (2026) Global stakeholder preferences for point-of-care HIV nucleic acid amplification tests: A conjoint study. PLoS One 21(10): e0361025. https://doi.org/10.1371/journal.pone.0361025 Editor: Elain Fu, Oregon State University, UNITED STATES OF AMERICA Received: April 20, 2026; Accepted: October 5, 2026; Published: October 22, 2026 Copyright: © 2026 Palamountain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: The data set is included in the Supplemental Information. Funding: This study was supported by the US National Institutes of Health (NIH). Funding for RPK and KMP was provided by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) under grant U54EB027049. Funding for YCM was provided by NIBIB under grant U54EB007958 and by the National Institute of Allergy and Infectious Diseases (NIAID) under grant UM1AI068613 (HPTN Core Laboratory). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors alone are responsible for the views expressed in this article, and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated. All authors have no competing interests to declare. Introduction As of 2023, an estimated 39.9 million people are living with HIV globally [ 1 ]. Although significant progress has been made in expanding access to antiretroviral therapy (ART), gaps in diagnosis, treatment adherence, and monitoring persist [ 2 ]. In response, UNAIDS launched the “95-95-95” global targets; by 2025, 95% of people living with HIV will know their HIV status (The First 95), 95% of those diagnosed will receive sustained ART (The Second 95), and 95% of those on ART will achieve viral suppression (The Third 95) [ 2 ]. Achieving these targets, which as of 2024 stood at 87-88-95, respectively, requires not only access to treatment but also effective tests ( Table 1 ) across the care cascade [ 2 , 3 ]. This begins with serologic testing, primarily antibody/antigen rapid diagnostic tests, which remain the primary method for achieving the First 95 target [ 4 , 5 ]. However, nucleic acid amplification tests (NAATs) are essential in specific contexts such as early infant diagnosis [ 4 ] and during PrEP initiation, where serologic tests may be unreliable [ 4 – 8 ]. A quantitative NAAT is also critical for treatment initiation to assess baseline viral levels and ongoing monitoring to track treatment success [ 9 – 13 ]. WHO defines viral suppression as 0.05) in influencing adoption decisions. Importance by Role: We also analyzed if preferences varied between Laboratory and non-Laboratory respondents. Results showed Laboratory respondents valued LOD (37.6% importance) and TAT (28.7% importance) only, whereas Non-Laboratory respondents valued LOD (31.1% importance), TAT (25.1% importance), and sample collection (18.1% importance). Other attributes—price, result format, and power—were not important (statistically not significant at p < 0.05) across all roles. Importance by Geography: We also analyzed if importance weights varied between Africa and Non-Africa respondents. Results showed respondents based in Africa value LOD (35.8% importance), TAT (30.7% importance), and sample-collection method (16.2% importance). For non-African respondents, the same attributes were important but varied in the weightage of importance. Non-African respondents indicated choices that suggest they valued LOD (33.8% importance), TAT (20.8% importance), and sample-collection method (17.9% importance). Notably, TAT was more important to the African respondents. Other attributes—price, result format, and power—were not important (statistically not significant at p < 0.05) across all respondents. Importance by Use Case Level: We also analyzed if importance weights varied between use cases prioritized by the survey respondents for POC NAAT. Results showed when initial diagnosis was prioritized, respondents valued LOD (36.1% importance) and TAT (42.9% importance) only, however, when initiating/monitoring was prioritized, respondents valued LOD (36.3% importance) and sample collection (26.7% importance). Other attributes—price, result format, and power—were not important (statistically not significant at p < 0.05) across all use-case levels. Importance by Health-System Level: We also analyzed if importance weights varied between health-system levels prioritized by the survey respondents for POC NAAT. At health centers and hospitals, LOD was the most important factor, followed by TAT. By contrast, at community or home, respondents placed the highest value on TAT (28.8% importance) and sample-collection method (25.9%), with LOD still considered important (15.7%) but less so than in other clinical settings. Consistent with the previous analyses, price, result format, and power were not important (statistically not significant at p < 0.05) across all health-system levels. Attribute-level utilities Next, we estimated part-worth (PW) utility coefficients. PWs are calculated from the linear regression described in the “Attribute Importance” section. PWs reflect the relative value participants assign to each level within an attribute—higher values indicate greater preference, whereas lower values signal lower desirability. These estimates reveal which attribute levels are driving preferences within each category. Table 5 shows the average PWs for each attribute across the entire sample as well as by role, geography, preferred use case, and preferred level of healthcare system. A PW utility of zero denotes the reference (omitted) level for each attribute (200 copies per mL, fingerstick, battery backup, $8, quantitative, and 15 minutes). These levels are selected to be the reference levels arbitrarily. Changing the reference levels does not change the results. Download: PNG larger image TIFF original image Table 5. Part-Worth (PW) Utility Coefficients. https://doi.org/10.1371/journal.pone.0361025.t005 In addition to relative preference, PW analysis allows us to identify the ideal test. The bolded values in Table 5 indicate the most preferred level within each attribute, that is, the level with the highest estimated PW. Across most groups, the ideal test is composed on 200 copies per mL, fingerstick sample, main power with battery backup, costs $8, quantitative results, and TAT of 15 minutes. Manufacturing the ideal test may not be possible due to budget or feasibility constraints, but the PWs analysis allows us to identify which products would be considered alternatives, as we elaborate in the Discussion section. Discussion Across all respondent groups, the highest-scoring test design included the following attributes: an LOD of 200 copies per mL, a cost of $10 per test (though some groups have higher PW to the $8 test), fingerstick sample collection, a 15-minute TAT, battery backup (though some groups have higher PW to the mains power with electricity test), and a quantitative-result format (though some groups have higher PW to the semi-quantitative test). Although this combination represents the highest theoretical preference, such a test may not be technically feasible. To achieve a 200 copies per mL detection limit using less than 200 μL of capillary blood (which would be the case using the pref
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