Journal of acquired immune deficiency syndromes (1999) · 2025
Preferences for HIV Pre-Exposure Prophylaxis Products and Delivery Models Among Cisgender Men, Transgender Persons, and Nonbinary Individuals Who Have Sex With Men in Seattle, Washington: A Discrete Choice Experiment.
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Violette Lauren R, Delacruz Jakar, Niemann Lisa A, Cannon Chase, Stekler Joanne D, Katz David A
Аннотация
BACKGROUND: Understanding preferences for HIV pre-exposure prophylaxis (PrEP) products and delivery models could better meet the needs of populations likely to benefit from PrEP and ultimately increase uptake.
SETTING: Public Health-Seattle & King County Sexual Health Clinic.
METHODS: Between August 2022 and December 2023, a convenience sample of individuals seeking HIV testing and participating in Project DETECT2 completed a discrete choice experiment (DCE). We used a D-efficient blocked fractional design and asked participants to choose between 2 hypothetical PrEP options composed of 5 attributes (modality, efficacy, dosing frequency, prescriber, and monitoring appointment format). We used multinomial logistic regression to estimate preference weights and relative importance overall and stratified by PrEP experience.
RESULTS: Three hundred twenty-five participants completed the DCE; 96 (29.5%) were PrEP naive and 229 (70.5%) were PrEP experienced. Ninety-nine percent efficacy (weight = 0.848, 95% CI: 0.769 to 0.927), 6-month dosing interval (weight = 0.381, 95% CI: 0.293 to 0.469), and pills (weight = 0.173, 95% CI: 0.085 to 0.261) were most preferred. There was a strong preference for PrEP delivery within a pharmacy (weight = 0.144, 95% CI: 0.059 to 0.228) or community-based organization (weight = 0.097, 95% CI: 0.011 to 0.183). Preference for combination online/in-person (weight = 0.086, 95% CI: 0.017 to 0.154) and in-person only monitoring appointments (weight = 0.061, 95% CI: -0.023 to 0.144) was similar. Efficacy had the highest relative importance (52.1%). Stratifying by PrEP experience did not change preference.
CONCLUSIONS: Participants preferred products with high efficacy and longer dosing intervals delivered in nonclinical spaces with in-person or online follow-up appointments. These data suggest that, although highly efficacious, longer acting products are preferred, a range of different modalities, prescribers, and monitoring methods may be needed to reach everyone who may benefit from PrEP.
SETTING: Public Health-Seattle & King County Sexual Health Clinic.
METHODS: Between August 2022 and December 2023, a convenience sample of individuals seeking HIV testing and participating in Project DETECT2 completed a discrete choice experiment (DCE). We used a D-efficient blocked fractional design and asked participants to choose between 2 hypothetical PrEP options composed of 5 attributes (modality, efficacy, dosing frequency, prescriber, and monitoring appointment format). We used multinomial logistic regression to estimate preference weights and relative importance overall and stratified by PrEP experience.
RESULTS: Three hundred twenty-five participants completed the DCE; 96 (29.5%) were PrEP naive and 229 (70.5%) were PrEP experienced. Ninety-nine percent efficacy (weight = 0.848, 95% CI: 0.769 to 0.927), 6-month dosing interval (weight = 0.381, 95% CI: 0.293 to 0.469), and pills (weight = 0.173, 95% CI: 0.085 to 0.261) were most preferred. There was a strong preference for PrEP delivery within a pharmacy (weight = 0.144, 95% CI: 0.059 to 0.228) or community-based organization (weight = 0.097, 95% CI: 0.011 to 0.183). Preference for combination online/in-person (weight = 0.086, 95% CI: 0.017 to 0.154) and in-person only monitoring appointments (weight = 0.061, 95% CI: -0.023 to 0.144) was similar. Efficacy had the highest relative importance (52.1%). Stratifying by PrEP experience did not change preference.
CONCLUSIONS: Participants preferred products with high efficacy and longer dosing intervals delivered in nonclinical spaces with in-person or online follow-up appointments. These data suggest that, although highly efficacious, longer acting products are preferred, a range of different modalities, prescribers, and monitoring methods may be needed to reach everyone who may benefit from PrEP.