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© 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Introduction

End‐user perspectives are vital to the design of new biomedical HIV prevention products. Conjoint analysis can support the integration of end‐user perspectives by examining their preferences of potential pre‐exposure prophylaxis (PrEP) products. The Microbicides Trial Network (MTN) 035 protocol examined three placebo rectal dosage forms (insert, enema and suppository) that could deliver PrEP prior to receptive anal sex (RAS).

Methods

Between April 2019 and July 2020, we enrolled 217 HIV‐negative, cisgender men who have sex with men (MSM; n = 172; 79.3%) and transgender people (n = 47; 20.7%) ages 18–35 into a randomized cross‐over trial across Malawi, Peru, South Africa, Thailand and the United States. Participants used each product prior to RAS over 4‐week periods. Participants completed a conjoint experiment where they selected between random profiles using seven features (dosage form, timing of use before sex, side effects, duration of protection, effectiveness, frequency of use and need for a prescription).

Results

Effectiveness was the strongest determinant of choice (30.4%), followed by modality (18.0%), potential side effects (17.2%), frequency of use (10.8%), duration of protection (10.4%), timing of use before sex (7.4%) and need for a prescription (5.9%). Relative utility scores indicated that the most desirable combination of attributes was a product with 95% efficacy, used 30 minutes before sex, offering a 3‐ to 5‐day protection window, used weekly, having no side effects, in the form of an enema and available over‐the‐counter.

Conclusions

Choice in next‐generation PrEP products is highly desired by MSM and transgender people, as no one‐size‐fits‐all approach satisfies all the preferences. MTN‐035 participants weighed product features differently, recognizing the need for diverse, behaviourally congruent biomedical options that fit the needs of intended end‐users.

Details

Title
A conjoint experiment of three placebo rectal products used with receptive anal sex: results from MTN‐035
Author
Bauermeister, José 1   VIAFID ORCID Logo  ; Lin, Willey 1 ; Tingler, Ryan 1 ; Liu, Albert 2   VIAFID ORCID Logo  ; Chariyalertsak, Suwat 3 ; Hoesley, Craig 4 ; Gonzales, Pedro 5 ; Ho, Ken 6 ; Kayange, Noel 7 ; Phillips, Thesla Palanee 8   VIAFID ORCID Logo  ; Johnson, Sherri 9 ; Brown, Elizabeth 10   VIAFID ORCID Logo  ; Zemanek, Jillian 10 ; Jacobson, Cindy E. 9 ; Doncel, Gustavo F. 11 ; Piper, Jeanna 12 

 University of Pennsylvania, Philadelphia, Pennsylvania, USA 
 Bridge HIV at the San Francisco Department of Public Health, San Francisco, California, USA 
 Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand 
 University of Alabama at Birmingham, Birmingham, Alabama, USA 
 IMPACTA, Asociación Civil Impacta Salud y Educación, San Miguel CRS, Lima, Perú 
 University of Pittsburgh, Pittsburgh, Pennsylvania, USA 
 Blantyre CRS, Johns Hopkins University Research Project, Blantyre, Malawi 
 Wits Reproductive Health and HIV Institute, Johannesburg, South Africa 
 FHI 360, Durham, North Carolina, USA 
10  Statistical Center for HIV/AIDS Research & Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA 
11  CONRAD, Eastern Virginia Medical School, Norfolk, Virginia, USA 
12  Division of AIDS, United States National Institute of Health, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA 
Section
RESEARCH ARTICLES
Publication year
2024
Publication date
Mar 1, 2024
Publisher
John Wiley & Sons, Inc.
e-ISSN
1758-2652
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2986752323
Copyright
© 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.