Preference for HIV Pre-exposure Prophylaxis Access Among Men who Have Sex With Men in China: A Discrete Choice Experiment.

IF 3.8 4区 医学 Q2 IMMUNOLOGY
Open Forum Infectious Diseases Pub Date : 2025-01-09 eCollection Date: 2025-01-01 DOI:10.1093/ofid/ofae742
Wenting Huang, Daniel Stegmueller, Jessica M Sales, Guodong Mi, Fei Yu, Yufen Liu, Patrick S Sullivan, Aaron J Siegler, Jason J Ong
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引用次数: 0

Abstract

Background: HIV pre-exposure prophylaxis (PrEP) is highly effective but not widely used by men who have sex with men (MSM; 27%) in China.

Methods: In June 2023, an online cross-sectional survey with a discrete choice experiment (DCE) was distributed to PrEP-eligible MSM in China who were at least 18 years old. The DCE explored attributes of PrEP modality (daily pill, on-demand pill, injections, implants), clinical care model (same-day, 2-visit, telehealth prescription), medication pickup (clinic, community health center, pharmacy, MSM-focused community-based organization, home delivery), enhanced support (self-management, smartphone app, text reminder, anonymous peer support group), and cost.

Results: A total of 1013 MSM completed the survey; the average age was 31 years, and a quarter had used PrEP. The most influential attributes were cost (relative importance: 64.6%), followed by PrEP modality (27.7%), medication pickup (4.0%), enhanced support (3.5%), and clinical care model (0.2%). The most preferred ways to access PrEP were no-cost on-demand pill, medication home delivery, self-management, and telehealth. The predicted uptake of on-demand PrEP was higher than other modalities, increasing from 22% with no subsidy to 79% with full subsidy, holding the other 3 attributes constant.

Conclusions: Chinese MSM have strong preferences regarding accessing PrEP: Low cost is a critical priority, especially important because medication and clinical care are currently entirely unsubsidized in China. Preferences for on-demand PrEP and home delivery indicate methods that the health care system can utilize to best meet the needs of MSM and factors that should be incorporated into future interventions.

中国男男性行为者对HIV暴露前预防的偏好:一个离散选择实验
背景:HIV暴露前预防(PrEP)非常有效,但在男男性行为者(MSM;27%)。方法:于2023年6月对中国18岁以上符合prep条件的男男性行为者进行在线横断面调查,并进行离散选择实验(DCE)。DCE探讨了PrEP模式(每日服药、按需服药、注射、植入)、临床护理模式(当日、2次就诊、远程医疗处方)、取药(诊所、社区卫生中心、药房、以男男性行为为重点的社区组织、送货上门)、增强支持(自我管理、智能手机应用、短信提醒、匿名同伴支持小组)和成本的属性。结果:共有1013名男男性行为者完成调查;平均年龄31岁,1 / 4使用过PrEP。影响最大的因素是费用(相对重要性:64.6%),其次是PrEP方式(27.7%)、取药(4.0%)、加强支持(3.5%)和临床护理模式(0.2%)。获得PrEP最受欢迎的方式是免费按需服药、药物送货上门、自我管理和远程医疗。按需PrEP的预测使用率高于其他模式,从没有补贴的22%增加到有全额补贴的79%,保持其他3个属性不变。结论:中国的男男性行为者对获取PrEP有强烈的偏好:低成本是关键优先事项,尤其重要的是,目前中国的药物和临床护理完全没有补贴。对按需PrEP和家庭分娩的偏好表明卫生保健系统可以利用的方法,以最好地满足男男性行为者的需求,以及应纳入未来干预措施的因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Open Forum Infectious Diseases
Open Forum Infectious Diseases Medicine-Neurology (clinical)
CiteScore
6.70
自引率
4.80%
发文量
630
审稿时长
9 weeks
期刊介绍: Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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