Imperial College Business School, Imperial College London, London, United Kingdom.
PLoS One. 2012;7(1):e28238. doi: 10.1371/journal.pone.0028238. Epub 2012 Jan 11.
The use of antiviral medications by HIV negative people to prevent acquisition of HIV or pre-exposure prophylaxis (PrEP) has shown promising results in recent trials. To understand the potential impact of PrEP for HIV prevention, in addition to efficacy data, we need to understand both the acceptability of PrEP among members of potential user groups and the factors likely to determine uptake.
Surveys of willingness to use PrEP products were conducted with 1,790 members of potential user groups (FSWs, MSM, IDUs, SDCs and young women) in seven countries: Peru, Ukraine, India, Kenya, Botswana, Uganda and South Africa. Analyses of variance were used to assess levels of acceptance across different user groups and countries. Conjoint analysis was used to examine the attitudes and preferences towards hypothetical and known attributes of PrEP programs and medications. Overall, members of potential user groups were willing to consider taking PrEP (61% reported that they would definitely use PrEP). Current results demonstrate that key user groups in different countries perceived PrEP as giving them new possibilities in their lives and would consider using it as soon as it becomes available. These results were maintained when subjects were reminded of potential side effects, the need to combine condom use with PrEP, and for regular HIV testing. Across populations, route of administration was considered the most important attribute of the presented alternatives.
Despite multiple conceivable barriers, there was a general willingness to adopt PrEP in key populations, which suggests that if efficacious and affordable, it could be a useful tool in HIV prevention. There would be a willingness to experience inconvenience and expense at the levels included in the survey. The results suggest that delivery in a long lasting injection would be a good target in drug development.
在最近的试验中，艾滋病毒阴性者使用抗病毒药物预防艾滋病毒感染或暴露前预防（PrEP）已显示出良好的效果。为了了解 PrEP 在艾滋病毒预防方面的潜在影响，除了疗效数据外，我们还需要了解潜在使用者群体对 PrEP 的可接受性以及可能决定采用率的因素。
在七个国家（秘鲁、乌克兰、印度、肯尼亚、博茨瓦纳、乌干达和南非）对 1790 名潜在使用者群体（性工作者、男男性行为者、静脉吸毒者、性交易的嫖客和暗娼以及年轻女性）进行了使用 PrEP 产品的意愿调查。方差分析用于评估不同使用者群体和国家之间的接受程度。联合分析用于检查对 PrEP 方案和药物的假设和已知属性的态度和偏好。总体而言，潜在使用者群体愿意考虑使用 PrEP（61%的人报告说他们肯定会使用 PrEP）。目前的结果表明，不同国家的关键使用者群体认为 PrEP 为他们的生活带来了新的可能性，并将在其上市后考虑使用。当受试者被提醒潜在的副作用、需要将 condom 与 PrEP 联合使用以及定期进行 HIV 检测时，这些结果仍然存在。在不同人群中，给药途径被认为是所提供替代方案中最重要的属性。
尽管存在多种可能的障碍，但在关键人群中普遍愿意采用 PrEP，这表明如果有效且负担得起，它可能是预防艾滋病毒的有用工具。在调查中包含的水平上，人们愿意经历不便和费用。结果表明，长效注射剂的输送将是药物开发的一个很好的目标。
