Preferences for Pre-exposure Prophylaxis (PrEP) among people who use drugs in Thailand: A discrete choice experiment

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-07-15 DOI:10.1016/j.drugpo.2025.104913

Ajaree Rayanakorn , Piyameth Dilokthornsakul , Donsuk Pongnikorn , Jason J. Ong , Warittha Tieosapjaroen

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引用次数: 0

Abstract

Background

Pre-exposure prophylaxis (PrEP) is effective in preventing HIV. However, engaging people who use drugs (PWUDs) in PrEP services remains challenging due to societal, legal, and structural barriers. This study examined preferences for PrEP services among people who use drugs in Thailand.

Methods

We conducted a discrete choice experiment (DCE) using a self-administered paper-based questionnaire from March to August 2024 at Thanyarak Chiang Mai Hospital. PWUDs were identified through hospital records. Random Parameters Logit (RPL) models were used to explore the drivers of PrEP use. RPL models with interactions examined heterogeneity in preferences for PrEP, and Latent Class Models identified subgroups with similar preferences for PrEP.

Results

Among 210 respondents, 87 % were male and had a mean age of 33 (±8.5) years. Cost was the most important attribute, followed by location, the friendliness of service providers, the types of PrEP and privacy. PWUDs expressed less preference with PrEP services offered at Key Population Led Health Services (KPLHS), services exclusively catering to PWUDs, with no significant preferences for other locations, interactions with unempathetic or inattentive staff, and services costing 200 THB (US$ 5.6) or 500 THB (US$ 14.1) per month. Compared to their counterparts, those unaware of PrEP were more likely to access the service through TelePrEP, while females preferred accessing PrEP through Key Population Led Health Services. Latent class model revealed that 29 % of respondents tended to favor TelePrEP, while the majority (71 %) were less likely to use PrEP services through Key Population Led Health Services or services provided by unfriendly staff.

Conclusions

Diverse PrEP provisions considering service location, the friendliness of service providers, and free access could improve PrEP uptake among people who use drugs. Developing innovative service delivery models that address group-specific preferences is essential.

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泰国吸毒者对暴露前预防（PrEP）的偏好：一项离散选择实验

暴露前预防（PrEP）是预防HIV的有效方法。然而，由于社会、法律和结构性障碍，使吸毒者参与预防服务仍然具有挑战性。这项研究调查了泰国吸毒者对PrEP服务的偏好。方法于2024年3月至8月在清迈坦雅叻医院进行离散选择实验（DCE）。通过医院记录确定pwud。采用随机参数Logit （RPL）模型探讨PrEP使用的驱动因素。相互作用的RPL模型检验了PrEP偏好的异质性，潜在类别模型确定了PrEP偏好相似的亚组。结果在210名受访者中，87%为男性，平均年龄为33（±8.5）岁。成本是最重要的因素，其次是地理位置、服务提供者的友好程度、PrEP的类型和隐私。pwud表示不太喜欢重点人群主导的健康服务（KPLHS）提供的PrEP服务，专门为pwud提供的服务，对其他地点没有明显的偏好，与缺乏同情心或不专心的工作人员互动，服务费用每月200泰铢（5.6美元）或500泰铢（14.1美元）。与他们的同行相比，那些不知道PrEP的人更有可能通过远程PrEP获得服务，而女性更愿意通过关键人群主导的卫生服务获得PrEP。潜在类别模型显示，29%的受访者倾向于支持远程PrEP，而大多数人（71%）不太可能通过关键人群主导的卫生服务或不友好的工作人员提供的服务使用PrEP服务。结论考虑服务地点、服务人员的友好性和免费获取等因素，提供多样化的PrEP服务可提高吸毒者的PrEP使用率。开发针对特定群体偏好的创新服务提供模式至关重要。

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

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.