Women's Global Health Imperative, RTI International, San Francisco, CA.
School of Public Health, University of California, Berkeley, CA.
J Acquir Immune Defic Syndr. 2019 Apr 1;80(4):394-403. doi: 10.1097/QAI.0000000000001945.
Integrating end-user perspectives into the design of new biomedical HIV prevention products is recognized as vital to informing the product development pipeline.
Kisumu, Kenya; and Soshanguve, South Africa.
We conducted a discrete choice experiment survey with 536 women aged 18-30 years to assess preferences for hypothetical HIV prevention products characterized by the attributes of efficacy, pregnancy prevention, delivery form, dosing frequency, and side effects. Participants included product-experienced women from Tablet, Ring, Injection as Options TRIO, a cross-over clinical study evaluating 3 placebo delivery forms (oral tablets, vaginal rings, and injections), and a product-naive sample recruited from the same communities. Analyses used random parameters logit and latent class models.
HIV prevention efficacy was a strong determinant of stated choice overall; however, in South Africa, delivery form was just as important, with an injection every 2-3 months most preferred and a daily oral tablet least preferred. In Kenya, product-experienced women preferred monthly injections and least preferred a monthly ring. Respondents indicated a preference for multipurpose prevention technologies that combine HIV and pregnancy protection. Latent class analyses confirmed these findings and delineated heterogeneity in preferences across subgroups defined by age, past experience with the delivery forms, and education.
Despite an overall preference for products with high efficacy, we identified attributes salient to future uptake and use of HIV prevention products. Preferences for injectable products underscored interest in this pre-exposure prophylaxis delivery form. Likewise, the multipurpose prevention technology feature was valued in both Kenya and South Africa and most influenced interest in vaginal rings.
将最终用户的观点纳入新的生物医学 HIV 预防产品的设计中，被认为对于为产品开发管道提供信息至关重要。
肯尼亚基苏木和南非索山古武。
我们对 536 名年龄在 18-30 岁之间的女性进行了离散选择实验调查，以评估她们对具有疗效、避孕、给药形式、给药频率和副作用等属性的假设性 HIV 预防产品的偏好。参与者包括来自 Tablet、Ring、Injection as Options TRIO 的产品体验女性，这是一项评估 3 种安慰剂给药形式（口服片剂、阴道环和注射剂）的交叉临床研究，以及从同一社区招募的产品无经验样本。分析使用随机参数对数和潜在类别模型。
HIV 预防效果总体上是决定选择的重要因素；然而，在南非，给药形式同样重要，每 2-3 个月注射一次最受欢迎，而每天口服片剂最不受欢迎。在肯尼亚，有经验的产品女性更喜欢每月注射，而最不喜欢每月环。受访者表示偏好将 HIV 和避孕保护相结合的多用途预防技术。潜在类别分析证实了这些发现，并在按年龄、过去使用给药形式的经验和教育程度划分的亚组之间描绘了偏好的异质性。
尽管总体上偏好具有高疗效的产品，但我们确定了对未来 HIV 预防产品的采用和使用有重要影响的属性。对注射产品的偏好强调了对这种暴露前预防给药形式的兴趣。同样，多用途预防技术的特点在肯尼亚和南非都受到重视，对阴道环的兴趣影响最大。
