Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca , Morelos, Mexico.
Division of Health Economics, Center for Health Systems Research, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico.
AIDS Behav. 2022 Mar;26(3):833-842. doi: 10.1007/s10461-021-03443-1. Epub 2021 Aug 27.
Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV but requires sustained adherence. Conditional economic incentives (CEIs) can improve medication-taking behaviors, yet preferences for programs that employ CEIs to increase PrEP use among male sex workers (MSWs) have not been investigated. We conducted a discrete choice experiment in Mexico City to elicit stated preferences for a CEI-based PrEP adherence program among MSWs. Respondents expressed their preferences for different program characteristics: incentive amount; incentive format; incentive type; and adherence-verification method. We used a random utility logit model to estimate the relative importance of each attribute and estimated willingness-to-pay. MSWs preferred a higher, fixed incentive, with PrEP adherence measured via hair sampling. MSWs were willing to forego up to 21% of their potential maximum CEI amount to ensure receipt of a fixed payment. MSWs are highly willing to accept a CEI-based intervention for PrEP adherence, if offered along with fixed payments.
暴露前预防（PrEP）在预防 HIV 方面非常有效，但需要持续坚持。有条件的经济激励（CEI）可以改善用药行为，但对于使用 CEI 来增加男男性行为者（MSW）中 PrEP 使用的项目的偏好尚未进行调查。我们在墨西哥城进行了一项离散选择实验，以了解 MSW 对基于 CEI 的 PrEP 坚持方案的既定偏好。受访者对不同的项目特征表达了他们的偏好：激励金额；激励形式；激励类型；和坚持验证方法。我们使用随机效用对数模型来估计每个属性的相对重要性，并估计支付意愿。MSW 更喜欢更高的固定激励，通过毛发采样来衡量 PrEP 的坚持。MSW 愿意放弃高达 21%的潜在最大 CEI 金额，以确保获得固定付款。如果与固定支付一起提供，MSW 非常愿意接受基于 CEI 的 PrEP 坚持干预。
