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

Author

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

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.

Suggested Citation

  • Matthew Quaife & Robyn Eakle & Maria A. Cabrera Escobar & Peter Vickerman & Maggie Kilbourne-Brook & Mercy Mvundura & Sinead Delany-Moretlwe & Fern Terris-Prestholt, 2018. "Divergent Preferences for HIV Prevention: A Discrete Choice Experiment for Multipurpose HIV Prevention Products in South Africa," Medical Decision Making, , vol. 38(1), pages 120-133, January.
    • Handle: RePEc:sae:medema:v:38:y:2018:i:1:p:120-133
    DOI: 10.1177/0272989X17729376
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    References listed on IDEAS

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    1. Sergio Torres-Rueda & Fern Terris-Prestholt & Mitzy Gafos & Pitchaya Peach Indravudh & Rebecca Giddings & Fiammetta Bozzani & Matthew Quaife & Lusine Ghazaryan & Carlyn Mann & Connie Osborne & Matthew, 2023. "Health Economics Research on Non-surgical Biomedical HIV Prevention: Identifying Gaps and Proposing a Way Forward," PharmacoEconomics, Springer, vol. 41(7), pages 787-802, July.
    2. Christine Michaels-Igbokwe & Gillian R. Currie & Bryanne L. Kennedy & Karen V. MacDonald & Deborah A. Marshall, 2021. "Methods for Conducting Stated Preference Research with Children and Adolescents in Health: A Scoping Review of the Application of Discrete Choice Experiments," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(6), pages 741-758, November.
    3. Elizabeth A Asiago-Reddy & John McPeak & Riccardo Scarpa & Amy Braksmajer & Nicola Ruszkowski & James McMahon & Andrew S London, 2022. "Perceived access to PrEP as a critical step in engagement: A qualitative analysis and discrete choice experiment among young men who have sex with men," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-21, January.
    4. Ostermann, Jan & Flaherty, Brian P. & Brown, Derek S. & Njau, Bernard & Hobbie, Amy M. & Mtuy, Tara B. & Masnick, Max & Mühlbacher, Axel C. & Thielman, Nathan M., 2021. "What factors influence HIV testing? Modeling preference heterogeneity using latent classes and class-independent random effects," Journal of choice modelling, Elsevier, vol. 40(C).
    5. Arora, Nikita & dit Sourd, Romain Crastes & Quaife, Matthew & Vassall, Anna & Ferrari, Giulia & Alangea, Deda Ogum & Tawiah, Theresa & Dwommoh Prah, Rebecca Kyerewaa & Jewkes, Rachel & Hanson, Kara & , 2023. "The stated preferences of community-based volunteers for roles in the prevention of violence against women and girls in Ghana: A discrete choice analysis," Social Science & Medicine, Elsevier, vol. 324(C).

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