使用联合分析测量接受度和对实施暴露前预防（PrEP）的偏好：在高危吸毒者中的原发性 HIV 预防中的应用。
Measuring Acceptability and Preferences for Implementation of Pre-Exposure Prophylaxis (PrEP) Using Conjoint Analysis: An Application to Primary HIV Prevention Among High Risk Drug Users.
机构信息
Department of Community Medicine & Health Care, University of Connecticut Health Center, 263 Farmington Avenue, MC 6325, Farmington, CT, 06030-6325, USA.
Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.
出版信息
AIDS Behav. 2018 Apr;22(4):1228-1238. doi: 10.1007/s10461-017-1851-1.
Although people who use drugs (PWUD) are one of the key risk populations who could benefit from the use of pre-exposure prophylaxis (PrEP), to date, little attention has been given to incorporating PrEP into HIV prevention approaches targeting this underserved group. This study investigated the acceptability of PrEP based on a number of known PrEP attributes among high-risk PWUD in a drug treatment setting. A total of 400 HIV-negative PWUD, who reported drug- and/or sex-related risk behaviors were recruited from a methadone clinic to complete a stated preference (full-profile conjoint) survey. Participants ranked the eight hypothetical PrEP program scenarios with varied combinations of six attributes related to PrEP (cost, dosing, efficacy, side-effects, treatment setting, and frequency of HIV testing). SPSS conjoint procedure was used to estimate the relative importance of each attribute and preferences across eight possible PrEP delivery programs. PrEP acceptability ranged from 30.6 to 86.3% with a mean acceptability of 56.2% across the eight hypothetical PrEP program scenarios. The PrEP program scenario with the highest acceptability had the following attribute levels: insurance covered, daily dosing, 95% effective, no side-effects, treatment at HIV clinic, and HIV testing needed every 6 months. The cost associated with PrEP was the most important attribute (relative importance score: RIS = 38.8), followed by efficacy (RIS = 20.5) and side effects (RIS = 11.9); other attributes had no significant effect. Our findings reported a high acceptability of PrEP in response to different PrEP program scenarios with different attribute profiles. As the result of having this information, researchers and policymakers will be better equipped for evidence informed targeting and dissemination efforts to optimize PrEP uptake among this underserved population.
尽管使用毒品的人（PWUD）是可以从使用暴露前预防（PrEP）中受益的关键风险人群之一，但迄今为止，针对这一未得到充分服务的群体，将 PrEP 纳入艾滋病毒预防方法的关注甚少。本研究调查了在药物治疗环境中，高危 PWUD 对基于一些已知 PrEP 属性的 PrEP 的可接受性。从美沙酮诊所招募了 400 名 HIV 阴性的 PWUD，他们报告了与毒品和/或性行为相关的风险行为，以完成一项既定偏好（完整概况联合）调查。参与者对八种假设的 PrEP 方案进行了排名，这些方案具有与 PrEP 相关的六个属性（成本、剂量、疗效、副作用、治疗场所和 HIV 检测频率）的不同组合。使用 SPSS 联合程序来估计每个属性和在八个可能的 PrEP 提供方案中的偏好的相对重要性。PrEP 的可接受性范围从 30.6%到 86.3%，在八个假设的 PrEP 方案中，平均可接受性为 56.2%。接受程度最高的 PrEP 方案具有以下属性水平：保险涵盖、每日剂量、95%有效、无副作用、在 HIV 诊所治疗和每 6 个月需要进行 HIV 检测。PrEP 相关成本是最重要的属性（相对重要性评分：RIS = 38.8），其次是疗效（RIS = 20.5）和副作用（RIS = 11.9）；其他属性没有显著影响。我们的研究结果报告了不同 PrEP 方案对不同属性配置的高接受程度。由于有了这些信息，研究人员和政策制定者将能够更好地进行基于证据的靶向和传播工作，以优化这一未得到充分服务的人群对 PrEP 的接受程度。
Zotero 插件