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Article ; Online: Willingness and preferences for long-acting injectable PrEP among US men who have sex with men: a discrete choice experiment.

Cole, Sam Wilson / Glick, Jennifer L / Campoamor, Nicola B / Sanchez, Travis H / Sarkar, Supriya / Vannappagari, Vani / Rinehart, Alex / Rawlings, Keith / Sullivan, Patrick S / Bridges, John F P

BMJ open

2024  Volume 14, Issue 4, Page(s) e083837

Abstract: Introduction: Cabotegravir long-acting injectable HIV pre-exposure prophylaxis (LA-PrEP) was shown to be safe and effective in multiple clinical trials. Increasing uptake and persistence among populations with elevated risk for HIV acquisition, ... ...

Abstract Introduction: Cabotegravir long-acting injectable HIV pre-exposure prophylaxis (LA-PrEP) was shown to be safe and effective in multiple clinical trials. Increasing uptake and persistence among populations with elevated risk for HIV acquisition, especially among men who have sex with men (MSM), is critical to HIV prevention.
Objective: This analysis aims to understand potential users' preferences for LA-PrEP, with audience segmentation.
Design: Willingness to use and preferences for LA-PrEP were measured in HIV-negative, sexually active MSM in the 2020 American Men's Internet Survey. Respondents answered a discrete choice experiment with paired profiles of hypothetical LA-PrEP characteristics with an opt-out option (no LA-PrEP). Conditional and mixed logit models were run; the final model was a dummy-coded mixed logit that interacted with the opt-out.
Setting: US national online sample.
Results: Among 2506 MSM respondents, most (75%) indicated a willingness to use LA-PrEP versus daily oral PrEP versus no PrEP. Respondents were averse to side effects and increasing costs and preferred increasing levels of protection. Respondents preferred a 2-hour time to obtain LA-PrEP vs 1 hour, with a strong aversion to 3 hours. Overall, there was an aversion to opting out of LA-PrEP, with variations: those with only one partner, no/other insurance or who were Black, Indigenous or People of Colour were significantly less likely to prefer LA-PrEP, while those who were Hispanic/Latino, college educated and <40 years significantly preferred LA-PrEP.
Conclusions: A large proportion of MSM expressed a preference for LA-PrEP over daily oral pills. Most respondents chose LA-PrEP regardless of cost, clinic time, side effects or protection level; however, preferences varied by sociodemographics. These varied groups likely require tailored intervention strategies to achieve maximum LA-PrEP uptake and persistence.
MeSH term(s) Humans ; Male ; Pre-Exposure Prophylaxis/methods ; Homosexuality, Male/psychology ; Adult ; HIV Infections/prevention & control ; United States ; Patient Preference/statistics & numerical data ; Anti-HIV Agents/administration & dosage ; Anti-HIV Agents/therapeutic use ; Middle Aged ; Young Adult ; Patient Acceptance of Health Care/statistics & numerical data ; Surveys and Questionnaires ; Pyridones/administration & dosage ; Adolescent ; Choice Behavior ; Delayed-Action Preparations ; Injections ; Diketopiperazines
Chemical Substances Anti-HIV Agents ; Pyridones ; cabotegravir (HMH0132Z1Q) ; Delayed-Action Preparations ; Diketopiperazines
Language English
Publishing date 2024-04-22
Publishing country England
Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID 2599832-8
ISSN 2044-6055 ; 2044-6055
ISSN (online) 2044-6055
ISSN 2044-6055
DOI 10.1136/bmjopen-2023-083837
Database MEDical Literature Analysis and Retrieval System OnLINE

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