Divergent Preferences for HIV Prevention: A Discrete Choice Experiment for Multipurpose HIV Prevention Products in South Africa

Matthew Quaife*, Robyn Eakle, Maria A. Cabrera Escobar, Peter Vickerman, Maggie Kilbourne-Brook, Mercy Mvundura, Sinead Delany-Moretlwe, Fern Terris-Prestholt

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

26 Citations (Scopus)
215 Downloads (Pure)

Abstract

BACKGROUND: The development of antiretroviral (ARV)-based prevention products has the potential to substantially change the HIV prevention landscape; yet, little is known about how appealing these products will be outside of clinical trials, as compared with the existing options.

METHODS: We conducted a discrete choice experiment (DCE) to measure preferences for 5 new products among 4 important populations in the HIV response: adult men and women in the general population (aged 18 to 49 y), adolescent girls (aged 16 to 17 y), and self-identifying female sex workers (aged 18 to 49 y). We interviewed 661 self-reported HIV-negative participants in peri-urban South Africa, who were asked to choose between 3 unique, hypothetical products over 10 choice sets. Data were analyzed using multinomial, latent class and mixed multinomial logit models.

RESULTS: HIV protection was the most important attribute to respondents; however, results indicate significant demand among all groups for multipurpose prevention products that offer protection from HIV infection, other STIs, and unwanted pregnancy. All groups demonstrated a strong preference for long-lasting injectable products. There was substantial heterogeneity in preferences within and across population groups.

LIMITATIONS: Hypothetical DCE data may not mirror real-world choices, and products will have more attributes in reality than represented in choice tasks. Background data on participants, including sensitive areas of HIV status and condom use, was self-reported.

CONCLUSIONS: These results suggest that stimulating demand for new HIV prevention products may require a more a nuanced approach than simply developing highly effective products. No single product is likely to be equally attractive or acceptable across different groups. This study strengthens the call for effective and attractive multipurpose prevention products to be deployed as part of a comprehensive combination prevention strategy.

Original languageEnglish
Pages (from-to)120-133
Number of pages14
JournalMedical Decision Making
Volume38
Issue number1
Early online date1 Sep 2017
DOIs
Publication statusPublished - Jan 2018

Keywords

  • discrete choice experiments
  • HIV prevention
  • key populations
  • pre-exposure prophylaxis
  • South Africa

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