School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 222L, Philadelphia, PA, 19104, USA.
Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, PA, USA.
Curr HIV/AIDS Rep. 2020 Jun;17(3):161-170. doi: 10.1007/s11904-020-00497-z.
Advances in short- and long-acting pre-exposure prophylaxis (PrEP) technologies have incentivized the need to understand how individuals make trade-offs and competing decisions regarding PrEP modalities. The purpose of this review was to examine how researchers have conceptualized and measured attributes that are either intuitive and emotional (System 1) or deliberative and cognitive (System 2) in conjoint analysis or discrete choice experiments focused on diverse PrEP technologies among men who have sex with men (MSM).
Across the 9 studies meeting inclusion criteria, 5 included oral PrEP, 3 included topical rectal microbicides, 4 included PrEP injectables, and 1 study focused on an HIV prevention vaccine. Studies have not used uniform metrics, making comparisons difficult. Researchers measured attributes linked to System 2 processing (e.g., cost, efficacy), yet none examined System 1 processing. There is not one product or attribute preferable to all groups. Prevention products will need to be developed and promoted to reflect that diversity. Given that PrEP technologies have been solely informed by System 2 attributes, efforts to integrate System 1 attributes into ongoing and future PrEP choice experiments are pivotal to advance PrEP acceptability research and interventions to support their implementation.
目的综述：短时间和长时间作用的暴露前预防（PrEP）技术的进步，促使我们需要了解个体如何权衡和决定 PrEP 模式。本文的目的是检验研究人员如何在针对男男性行为者（MSM）的不同 PrEP 技术的联合分析或离散选择实验中，将直观的、情绪化的（系统 1）或深思熟虑的、认知的（系统 2）属性进行概念化和测量。
最近发现：在符合纳入标准的 9 项研究中，有 5 项研究涉及口服 PrEP，3 项研究涉及局部直肠杀微生物剂，4 项研究涉及 PrEP 注射剂，1 项研究关注 HIV 预防疫苗。研究尚未使用统一的指标，难以进行比较。研究人员测量了与系统 2 处理相关的属性（例如，成本、功效），但没有研究系统 1 处理。没有一种产品或属性是所有群体都偏好的。需要开发和推广预防产品，以反映这种多样性。鉴于 PrEP 技术仅由系统 2 属性提供信息，将系统 1 属性纳入正在进行和未来的 PrEP 选择实验中的努力，对于推进 PrEP 可接受性研究和干预措施以支持其实施至关重要。
