Long-Acting Injection and Implant Preferences and Trade-Offs for HIV Prevention Among South African Male Youth
Autor: | Siyaxolisa Sindelo, Miriam Hartmann, Elizabeth T. Montgomery, Carol Mansfield, Marco Boeri, Erica N Browne, Alexandra M. Minnis, Sheily Ndwayana, Millicent Atujuna, Linda-Gail Bekker |
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Rok vydání: | 2021 |
Předmět: |
Male
Adolescent Anti-HIV Agents media_common.quotation_subject HIV Infections 030312 virology Article Men who have sex with men South Africa Young Adult 03 medical and health sciences Humans Pharmacology (medical) Product (category theory) Duration (project management) media_common Drug Implants 0303 health sciences End user Data Collection Patient Preference Discretion Preference Latent class model Regimen Infectious Diseases Delayed-Action Preparations HIV-1 Psychology Demography |
Zdroj: | J Acquir Immune Defic Syndr |
ISSN: | 1525-4135 |
Popis: | BACKGROUND Long-acting pre-exposure prophylaxis (LA-PrEP) formulated as implants and injections are promising prevention method strategies offering simplicity, discretion, and long dose duration. Men are important end users of LA-PrEP, and early assessment of their preferences could enhance downstream male engagement in HIV prevention. METHODS A discrete-choice experiment survey was conducted with 406 men, aged 18-24, in Cape Town, South Africa, to assess preferences for 5 LA-PrEP attributes with 2-4 pictorially-depicted levels: delivery form, duration, insertion location, soreness, and delivery facility. Latent class analysis was used to explore heterogeneity of preferences and estimate preference shares. RESULTS The median age was 21 (interquartile range 19-22), and 47% were men who have sex with men. Duration was the most important product attribute. Latent class analysis identified 3 classes: "duration-dominant decision makers" (46%) were the largest class, defined by significant preference for a longer duration product. "Comprehensive decision makers" (36%) had preferences shaped equally by multiple attributes and preferred implants. "Injection-dominant decision makers" (18%) had strong preference for injections (vs. implant) and were significantly more likely to be men who have sex with men. When estimating shares for a 2-month injection in the buttocks with mild soreness (HPTN regimen) vs. a 6-month implant (to arm) with moderate soreness (current target), 95% of "injection-dominant decision makers" would choose injections, whereas 79% and 63% of "duration-dominant decision makers" and "comprehensive decision makers" would choose implant. CONCLUSIONS Young South African men indicated acceptability for LA-PrEP. Preferences were shaped mainly by duration, suggesting a sizeable market for implants, and underscoring the importance of product choice. Further research into men's acceptability of LA PrEP strategies to achieve engagement in these HIV prevention tools constitutes a priority. |
Databáze: | OpenAIRE |
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