Minnis AM, Browne EN, Boeri M, Agot K, van der Straten A, Ahmed K, Weinrib R, Mansfield C. Young women's stated preferences for biomedical HIV prevention: results of a discrete choice experiment in Kenya and South Africa. J Acquir Immune Defic Syndr. 2019 Jan 9. doi: 10.1097/QAI.0000000000001945.


BACKGROUND: Integrating end-user perspectives into the design of new biomedical HIV prevention products is recognized as vital to informing the product development pipeline.

SETTING: Kisumu, Kenya; Soshanguve, South Africa

METHODS: We conducted a discrete choice experiment survey with 536 women aged 18-30 to assess preferences for hypothetical HIV prevention products characterized by the attributes of efficacy, pregnancy prevention, delivery form, dosing frequency and side effects. Participants included product-experienced women from TRIO, a cross-over clinical study evaluating three placebo delivery forms (oral tablets, vaginal rings and injections), and a product-naïve sample recruited from the same communities. Analyses used random parameters logit and latent class models.

RESULTS: HIV prevention efficacy was a strong determinant of stated choice overall; however, in South Africa, delivery form was just as important, with an injection every 2-3 months most preferred and a daily oral tablet least preferred. In Kenya, product-experienced women preferred monthly injections and least preferred a monthly ring. Respondents indicated a preference for multi-purpose prevention technologies (MPTs) that combine HIV and pregnancy protection. Latent class analyses confirmed these findings and delineated heterogeneity in preferences across subgroups defined by age, past experience with the delivery forms, and education.

CONCLUSIONS: Despite an overall preference for products with high efficacy, we identified attributes salient to future uptake and use of HIV prevention products. Preferences for injectable products underscored interest in this pre-exposure prophylaxis (PrEP) delivery form. Likewise, Confidential – Accepted for publication in JAIDS (August 2018) 3 the MPT feature was valued in both Kenya and South Africa and most influenced interest in vaginal rings.

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