Preferences for HIV prevention conditional cash transfers among Black/African American and Latinx cisgender MSM in Los Angeles.

Abstract

Objectives: In Los Angeles, cisgender men who have sex with men (MSM) - particularly Black/African American and Latinx individuals - are a high-priority population for new HIV prevention interventions. Incentive programs that pay people for engaging in healthy behaviors, also known as "conditional cash transfers" (CCTs), are a promising strategy, but there is little evidence about their use in Black/African American and Latinx cisgender MSM.

Design and methods: We surveyed 133 cisgender MSM who identified as Black/African American or Latinx and included a discrete choice experiment to elicit their preferences for CCTs to incentivize preexposure prophylaxis (PrEP) use and, separately, HIV testing.

Results: Our findings suggest that respondents preferred more frequent payments of higher monetary value (e.g., a 35.2 percentage point increased probability of choosing a PrEP use CCT with $1200 versus $300 payment, and a 49.7 percentage point increased probability of choosing an HIV testing CCT with $1200 versus $300 payment). Additionally, respondents showed a preference for receiving CCT payments in cash over gift card payments (a 9.4 percentage point increased preference in the PrEP use CCT, and an 11 percentage point increased preference in the HIV testing CCT), particularly among those who were unemployed. Younger respondents had a stronger preference for more frequent payments. Higher monetary amounts were more strongly preferred by those with greater educational attainment and those who were employed.

Conclusions: This preimplementation research highlights important, and heterogeneous, preferences in the design details of a HIV prevention CCT for Black/African American and Latinx cisgender MSM in Los Angeles.