肯尼亚通过在线药房提供的艾滋病毒暴露前和暴露后预防服务的支付意愿。

Willingness to pay for HIV pre- and post-exposure prophylaxis services delivered via an online pharmacy in Kenya.

作者信息

Montaño Michalina A, Chen Yilin, Saldarriaga Enrique M, Thuo Nicholas, Kiptinness Catherine, Stergachis Andy, Mugambi Melissa L, Ngure Kenneth, Ortblad Katrina F, Sharma Monisha

机构信息

Vaccine and Infectious Diseases Division (VIDD), Fred Hutchinson Cancer Center, Seattle, USA.

The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, USA.

出版信息

BMC Health Serv Res. 2025 Apr 22;25(1):576. doi: 10.1186/s12913-025-12766-x.

DOI:10.1186/s12913-025-12766-x

PMID:40264148

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12013023/

Abstract

BACKGROUND

HIV pre- and post-exposure prophylaxis (PrEP/PEP) provision via online pharmacies could expand reach of HIV prevention in Eastern and Southern Africa, but designing sustainable delivery models will require assessing the amount potential users are willing to pay for online PrEP/PEP provision.

METHODS

We administered willingness to pay (WTP) questionnaires to both potential online PrEP users and current online PrEP/PEP users in Nairobi, Kenya using a stated preference approach to measure the amount participants were willing to pay for PrEP/PEP service delivery components. Participants ≥ 18 years were recruited via banner ads on an online pharmacy website on pages displaying sexual health products. We used multivariable gamma regression models to assess characteristics associated with differences in mean WTP for a 30-day PrEP or 28-day PEP course (including HIV self-testing, remote clinical consultation, drugs, and delivery fees).

RESULTS

From May 2022 and December 2023, 1,512 participants completed WTP questionnaires: 772 potential online PrEP users and 740 current online PrEP/PEP users. Most participants (98.3%, 1486/1,512) were willing to pay some amount for online PrEP services. For a one-month PrEP supply, potential online PrEP users were willing to pay 1388 KSH ($11.77 USD) and current online PrEP/PEP users were willing to pay 1271.2 KSH ($10.77 USD) on average. Most current online PrEP/PEP users (81.4%, 602/740) were also willing to pay for online PEP services; for a 28-day PEP supply, they were willing to pay 812.9 KSH ($6.89 USD) on average. Among potential online PrEP users, male sex, current enrollment in school, high income, and a history of online pharmacy purchases were associated with higher WTP for PrEP. Among current online PrEP/PEP users, higher income and prior online pharmacy purchases were associated with higher WTP for PrEP, and older age (> 24) and prior online pharmacy purchases were associated with higher WTP for PEP.

CONCLUSION

Most potential and current online PrEP/PEP users in Nairobi were willing to pay for online pharmacy-based PrEP/PEP and demonstrated similar WTP. Providing PrEP/PEP through online pharmacies may sustainably expand coverage of these HIV prevention services.

摘要

背景

通过在线药店提供艾滋病毒暴露前和暴露后预防（PrEP/PEP）可以扩大东非和南部非洲艾滋病毒预防的覆盖面，但设计可持续的服务模式需要评估潜在用户愿意为在线PrEP/PEP服务支付的费用。

方法

我们在肯尼亚内罗毕对潜在的在线PrEP用户和当前的在线PrEP/PEP用户进行了支付意愿（WTP）问卷调查，采用陈述偏好法来衡量参与者愿意为PrEP/PEP服务提供组件支付的金额。通过在线药店网站上展示性健康产品页面的横幅广告招募了年龄≥18岁的参与者。我们使用多变量伽马回归模型来评估与30天PrEP疗程或28天PEP疗程（包括艾滋病毒自我检测、远程临床咨询、药物和配送费用）的平均支付意愿差异相关的特征。

结果

从2022年5月到2023年12月，1512名参与者完成了支付意愿问卷调查：772名潜在的在线PrEP用户和740名当前的在线PrEP/PEP用户。大多数参与者（98.3%，1486/1512）愿意为在线PrEP服务支付一定费用。对于一个月的PrEP供应量，潜在的在线PrEP用户平均愿意支付1388肯尼亚先令（11.77美元），当前的在线PrEP/PEP用户平均愿意支付1271.2肯尼亚先令（10.77美元）。大多数当前的在线PrEP/PEP用户（81.4%，602/740）也愿意为在线PEP服务付费；对于一个28天的PEP供应量，他们平均愿意支付812.9肯尼亚先令（6.89美元）。在潜在的在线PrEP用户中，男性、目前在校就读、高收入以及有在线药店购买史与更高的PrEP支付意愿相关。在当前的在线PrEP/PEP用户中，高收入和之前的在线药店购买与更高的PrEP支付意愿相关，而年龄较大（>24岁）和之前的在线药店购买与更高的PEP支付意愿相关。