Table 3 Summary of attribute labels, lay terminologies, labels of plausible levels, and illustrative quotes in Northwest Ethiopia, 2022

Participants/others seen at the same visit

Individual appointment versus an appointment that includes other patients

‘‘I prefer the individual-based service to avoid disclosing my status when I form groups and take drugs together with the other clients’’. (40 years old male)

‘‘I prefer the individualized service to avoid clashing with other group members regarding the scheduled time to meet’’. (72 years old male)

Individual

‘‘I prefer the group-based service since we have an opportunity of sharing ideas’’. (22 years old male)

‘‘I prefer the group-based service since it helps us to support one another by strengthening our social interactions. It also saves our time to come here individually and use our time for our work by taking drugs in the village’’. (40 years old female)

Group

ART packaging

Patients stated preferences for ART packaging attributes

‘‘I also expect that the drug package should be changed since the current bottle-based package created discrimination by others as they could easily identify it. The bottle should be changed so that the container can handle many drugs and even we can put it in our pocket to avoid the direct advertising act of the current package. (33 years old female)

Need for change of drug package

‘‘I don’t have any problem with the drug packaging including the bottle sound. I use festal to carry my drugs since there is a large number of drugs. But, there may be stigma from the community to carrying a large volume of drugs for some clients’’. (57 years old female)

No need for a change of drug package

ART room labeling

Branding of ART clinics

‘‘I prefer the clear labeling of the ART room to help me in identifying the service delivery room’’. (72 years old male)

Clear labeling of ART room

‘‘I prefer the non-posting of the room to avoid discrimination by others while I get into this service room’’. (22 years old male)

No clear labeling of ART room

Buddy system

Means someone can pick up clients’ meds if they are not due for a provider visit

‘‘I prefer having the other person to assist me in drug-taking since there may be some time inconvenience for me to come here’’. (33 years old female)

‘‘It would be better to have other persons who assist in case of bedridden or paralyzed cases’’. (72 years old male)

Buddy system in place

‘‘I prefer to take drugs myself since I will not be happy if another person brings drugs for me that may not be trusted like me’’. (40 years old male)

‘‘I prefer to come physically here to be checked about my health status and whether the drug is working or not. It should not be thought of simply taking drugs from here’’. (25 years old female)

No buddy system in place

Distance from residence to a clinic

The proximity of a health facility to home

‘‘I prefer the clients get the service in a near place. It reduces time, costs for transportation and could help to engage in other work activities’’. (38 years old male)

Near

‘‘It is my interest to come from a remote place since there is still a stigma in our community while getting service in my locality’’. (33 years old female)

Far

Drug administration

Form of drug administration

‘‘It could be better if there is a vaccination like for the other diseases or an injection that could be used at least for one year’’. (25 years old female)

Pill based

Injection

Drug formulation

Novel drug formulation methods

‘‘I would be happy if there is a curable drug for us or drugs with fewer side effects or some additives in the drug that boosts the client’s immunity like vitamins’’. (33 years old female)

‘‘I expect there is a drug that builds our body like proteins in the drug so that you will be fat and similar to other HIV naïve people’’. (40 years old male)

Drug with additives and/or protein

‘‘The current pill-based drug has side effects on the stomach. It needs reconsideration’’. (38 years old male)

Drugs with fewer side effects

‘‘If possible I prefer if there is a permanent cure for HIV. I would stop visiting this hospital if there is a cure for HIV’’. (38 years old male)

Effective or curable drug

Frequency of receiving ART refills

Frequency of routine visits for ART refill

‘‘I prefer to come every three months here. It could help me to be checked my health status regularly. If I take the drugs every 6 months or yearly, I may be sick with an opportunistic infection and my viral load could be increased due to the long time to check my status by the providers’’. (57 years old female)

Every 3 months

‘‘I prefer to come every 6 months per year. But we can come here if we become sick in between the appointment dates’’. (38 years old female)

Every 6 months

‘‘I prefer to come once per year if I am healthy. It avoids transport costs and losing our daily work there at our locality. I may come at any time here if I have illness in between’’. (32 years old female)

Yearly

Labeling of ART package

Labeling for medicines

‘‘I don’t care about it [labeling of drug package]. There may be some others who may discriminate against us [clients with HIV on ART] when they [others] see the package and read the labeling of ARV drugs on the boxes’’. (38 years old female)

Medicine labels must be clear

‘‘I think there should not be the labeling of the drug package to avoid being readable by other people than me like my child. She may search via Google and know about her status’’. (33 years old female)

Medicine labels must not be clear

Location of ART service delivery

Preferred place of service for patients

‘‘I prefer the facility-based service since there may be a problem that will occur to give service at the community level by the current level of understanding. Providers may break confidentiality to let know others know about my status.’’. (33 years old female)

‘‘I prefer the facility-based ART service since the clients could get their providers in time and get appropriate service here. I have a concern there in the community that the providers may not deliver service like the providers in the facility. I may not be at home on the appointment date or I may be not aware of the exact appointment date there and I may create a problem for my providers in this case’’. (72 years old male)

Health facility

‘‘I prefer the community-based service since it [community-based service] saves time and lets clients know each other’’. (57 years old female)

‘‘I would be happy if the service is given at the community level since it avoids a long queue at this hospital and waiting time’’. (40 years old female)

Community

Preferences on involvement in treatment decision-making

Preferred participation and roles of patient and provider in treatment decision-making

‘‘I prefer a joint decision to select the model. There could be sharing of each idea by the clients and the providers. There should be an agreement between the two entities. There may be damage if one of the two simply selects the model’’. (25 years old female)

Make treatment decisions together with their provider

‘‘I couldn’t decide my model of choice. The provider should select the appropriate options since he knows the benefits and harms of this approach. The clients shouldn’t select the options for them rather the providers should select them’’. (40 years old male)

Providers making treatment decisions entirely by themselves

‘‘I prefer to select the model of my choice since I have a reason to choose from depending on my context. The provider should not decide for me’’. (72 years old male)

Patients make treatment decisions on their own

The person providing ART refills

The person who delivers ART refill services

‘‘I prefer the healthcare workers since they have their training. They can give the drugs by knowing the benefits and the harms. But in the case of the HEW or peer leaders, they lacked the appropriate knowledge and even they may wrongly exchange our drugs. I never trust them in this regard’’. (27 years old female)

‘‘I prefer the healthcare workers since they are trained to identify and manage the problems that I may have by critically evaluating my health status. However, the peer leaders are similar to me in terms of knowledge and couldn’t provide drugs for me properly’’. (38 years old male)

‘‘I prefer the healthcare workers to deliver the ART service. I don’t accept the peer leaders distributing our drugs since there is discrimination by the local community perceiving us having a meeting of HIV-positive people there’’. (40 years old female)

Healthcare workers

‘‘I prefer the health extension workers to give me drugs since I can go to her without notifying my status’’. (40 years old male)

Health extension workers

‘‘I prefer the peer leaders to bring us our drugs since they know everything and they have experience of drug-taking. They give more empathy to us compared to health extension and health care workers. Others couldn’t appreciate the context despite they have trained on the disease and the drug and give the service by reading on it’’. (40 years old female)

Peers

Provider’s attitude

Staff attitude while in care and treatment

‘‘My choice depends on the provider you get every visit. You may not get the provider that initially hosts you when you come here at your appointment. There is a difference in the kindness of the providers while giving service to us. I had one female provider who treats me with a bright face. Only a few providers are showing their good approach to us. There may be a behavioral problem by providers due to an increased load of clients’’. (38 years old male)

Rude

Nice

The spatial organization of service

Choice of separate or integrated service rooms

‘‘I prefer the separate building of the ART room to avoid the associated stigma if the ART room is available with other service rooms of the health facility’’. (72 years old male)

Separate service room

‘‘I prefer the service should be given with another service in the same room to avoid HIV status. The providers should treat them accordingly based on the clients’ situation instead of a separate service for ART’’. (33 years old female)

‘‘I would be okay if the service is connected with other services. It is similar to other services in the hospital. I have raised a question for myself why the service room is isolated from other service delivery rooms in the same facility’’. (22 years old female)

Integrated HIV and other services room

Time of facility operation

Health facility’s opening days and hours for ART refill

‘‘I prefer the usual working days and hours since it is enough to get the service at that time’’. (38 years old female)

Workweek and usual hours

‘‘I prefer the weekend-based service since I come here freely to take drugs these days’’. (22 years old female)

Weekend service only

‘‘I prefer the extra facility opening time especially Saturday and Sunday in addition to the usual working hours and days. I am not comfortable with the facility openings before 2:30 in the morning and after 11:30 in the afternoon since we do not come to this hospital at such times’’. (40 years old female)

Workweek and weekend days

‘‘I choose a 24-h ART service in this hospital since we may be sick at any time. We get the service in case of difficulty if the facility is open all days including night’’. (25 years old female)

24 h of the day at any time of the week

Time spent at clinics in ART pick-ups

Waiting time for registration, consultation, and ART pick-ups

‘‘I would prefer to get service in the shortest time since I am busy either going to work or school. But, if the service demands to wait for more, I would wait here instead’’. (22 years old male)

Less waiting time

‘‘I prefer to wait a long time to learn from my providers about the drug and the related things. I also want to talk with other clients in this hospital. I would be happy when I come here and see other clients taking drugs like me. I become frustrated when I am alone in the rural area of my home’’. (40 years old female)

More waiting time

The total cost of a visit

The total cost of the visit includes transportation, direct medical costs (e.g., consultation or booking fee, lab costs if not available at a public facility, non-ARV drug costs), and costs of food

‘‘I will pay whatever transport cost I have been requested to come here. I have health insurance and do not pay other payments in this hospital’’. (40 years old female)

Willing to pay the cost of transport

‘‘I believe that the free service that is currently being done is a good one. I recommend a balanced payment or a free service for those clients unable to pay for it [service]’’. (33 years old female)

‘‘I want there should be a free service related to HIV and other illnesses since living nowadays is becoming hard and there are some clients who live in poverty unable to cover the costs of medications’’.(27 years old female)

‘‘I prefer the service free of charge. There should be a special arrangement from the facility to cover the cost of transportation for those clients who do not generate income like old persons’’. (25 years old female)

Free and/or subsidized cost