# Using a discrete choice experiment to determine preferences for STI testing models for Black adolescent males

> **NIH NIH R21** · EMORY UNIVERSITY · 2023 · $205,274

## Abstract

PROJECT SUMMARY
Of the 26 million new sexually transmitted infections (STI) in 2018, almost half were among adolescents (15-19
years old) and young adults (20-24 years old). Millions of cases remain undiagnosed and untreated, particularly
among male teens. Less than 3% of sexually active male teens have had an STI test in the past 12 months
versus 26% of their female peers. Male teens are more likely to forego testing than female teens due to greater
confidentiality concerns, cost/insurance barriers, and lower self-perceived risk. COVID-19 has exacerbated
barriers to STI care, as testing services have plummeted by 66% since March 2020. There is great urgency to
develop innovative and effective methods to screen adolescent males for STIs: as males are largely
asymptomatic, their untreated STIs can be transmitted unknowingly to other sexual partners. Untreated STIs can
lead to male and female infertility and increase one’s susceptibility to contracting HIV. The objective of this R21
is to use an innovative, user-centered approach, a discrete choice experiment, to determine the preferences for
STI testing models among Black adolescent males. In a discrete choice experiment (DCE), a methodology that
has been widely used to inform the design/adoption of health services, respondents are presented with two
services with different attributes and are asked to choose which one they prefer (e.g., Testing Model A or B).
This series of choice-tasks elucidates the relative importance of certain attributes as well as acceptable trade-
offs. Importantly, DCEs can be used to highlight shared but distinct preferences within different groups of Black
adolescent males, which may justify the development of multiple, tailored STI testing models. The Early-
Investigator-led team, with extensive expertise in recruiting Black youth, will accomplish this objective through
two aims: Aim 1 will build the DCE collaboratively with a community-based Youth Advisory Board comprised of
15 Black male adolescents from Atlanta, GA. Qualitative methods such as interviews, focus groups, and pile-
sort exercises will be used to define the testing attributes (e.g., test location, time till results) which are most
important to youth; these attributes will be integrated into the experimental design of the DCE. Aim 2 will leverage
multi-platform community-based and online strategies to recruit a heterogenous sample of 500 Black male
adolescents to participate in a 15-minute online DCE. A latent class analysis will be used to elucidate preference
heterogeneity for STI testing, explore groups or classes with distinct attribute preferences, and assess
associated behaviors/characteristics. The research approach will be anchored in DCE best practices and in the
Phenomenological Variant of Ecological Systems Theory, a framework that recognizes the unique contexts in
which Black youth develop. This R21 innovatively explores a growing health disparity in a population often
neglected in research. A...

## Key facts

- **NIH application ID:** 10691449
- **Project number:** 5R21HD107409-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Melissa Kottke
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $205,274
- **Award type:** 5
- **Project period:** 2022-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10691449

## Citation

> US National Institutes of Health, RePORTER application 10691449, Using a discrete choice experiment to determine preferences for STI testing models for Black adolescent males (5R21HD107409-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10691449. Licensed CC0.

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