Preferences for pre-exposure prophylaxis for HIV: A systematic review of discrete choice experiments

Luh Putu Lila Wulandari; Shi Yi He; Christopher K Fairley; Benjamin R Bavinton; Heather Marie-Schmidt; Virginia Wiseman; Rebecca Guy; Weiming Tang; Lei Zhang; Jason J Ong

doi:10.1016/j.eclinm.2022.101507

Preferences for pre-exposure prophylaxis for HIV: A systematic review of discrete choice experiments

EClinicalMedicine. 2022 Jul 9:51:101507. doi: 10.1016/j.eclinm.2022.101507. eCollection 2022 Sep.

Authors

Luh Putu Lila Wulandari^{1

2}, Shi Yi He³, Christopher K Fairley^{4

5}, Benjamin R Bavinton¹, Heather Marie-Schmidt^{6

7}, Virginia Wiseman^{1

8}, Rebecca Guy¹, Weiming Tang⁹, Lei Zhang^{3

4

5

10}, Jason J Ong^{3

4

5

11}

Affiliations

¹ The Kirby Institute, University of New South Wales, Sydney, Australia.
² Faculty of Medicine, Udayana University, Bali Indonesia.
³ China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
⁴ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.
⁵ Central Clinical School, Monash University, Melbourne, Australia.
⁶ UNAIDS Regional Office for Asia and the Pacific, Bangkok, Thailand.
⁷ Global HIV, Hepatitis and STIs Programme, World Health Organization, Geneva, Switzerland.
⁸ Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom.
⁹ Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States.
¹⁰ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China.
¹¹ Department of Clinical Research, London School of Hygiene & Tropical Medicine, Keppel Street London, London, United Kingdom.

Abstract

Background: We aimed to systematically review the health preference literature using discrete choice experiments (DCEs), an attribute-based stated preference method, to investigate patient preferences for HIV pre-exposure prophylaxis (PrEP).

Methods: A search in PubMed, Scopus, CINAHL, and Embase was conducted on July 1, 2021, and updated on November 3, 2021. We used two concepts to create our search strategy: (1) discrete choice experiments/conjoint analysis/best-worst scaling, and (2) HIV PrEP.The study is registered in PROSPERO (CRD42021267026).

Findings: In total, 1060 studies were identified, and 18 were included in the analysis. Various attributes were examined, including dosing regimen, type of PrEP products, side effects, other side benefits, cost, effectiveness, dispensing venue, and additional support services. Dosing frequency, cost, the effectiveness of PrEP, dispensing venue, and side effects were the most common attributes examined in DCEs. Despite significant heterogeneity in preferences across subpopulations, overall, the most important attributes were cost (28%, 5/18), effectiveness (28%, 5/18) followed by dosing frequency (17%, 3/18).

Interpretation: Notably, in studies where all of these three attributes were examined, some individuals would trade effectiveness for cost or vice versa. Ensuring PrEP is low cost or free, widely disseminating information of its effectiveness and advancements in reducing dosing frequency could accelerate the uptake of PrEP for those who would benefit from PrEP the most.

Funding: None.

Keywords: Discrete choice experiment; HIV; Pre-exposure prophylaxis; Preferences; Systematic review.

Publication types

Review

Abstract

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