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Understanding preferences for pre-exposure prophylaxis (PrEP) among people who would benefit from PrEP in the United States
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5th HIV Research for Prevention Conference (HIVR4P 2024); October 06-10, 2024; Lima, Peru
Lewis Kopenhafer1, Megan Dunbar2, Joshua Gruber2*, Chris Nguyen2, James Jarrett2, Nate Way1, and Kathleen Beusterien1
1Oracle America, Inc., CA, USA; 2Gilead Sciences, Inc., Foster City, CA, USA
*Presenting Author
BACKGROUND: PrEP is effective in preventing HIV-1 infection; however, PrEP utilization is low, particularly among populations disproportionately impacted by HIV-1, with only 36% of people who would benefit from PrEP (PWBP) in the US utilizing PrEP. To better understand PrEP modality preferences among PWBP and provide insights for increasing PrEP utilization, we conducted a cross-sectional survey.
METHODS: Concept elicitation interviews among PWBP informed development of an online discrete choice experiment survey for participants to rate attributes of daily and long-acting PrEP. Using resulting preference weights, share of preference for different PrEP options were simulated. Recruitment via patient advocacy groups and HCP referrals ensured a diverse US sample inclusive of disproportionally affected populations across PrEP-use status: current PrEP user (CP), former PrEP user (FP), and PrEP-naïve PWBP (PN).
RESULTS: Overall, 546 participants completed the survey (112 CP; 150 FP; 284 PN): mean age (39.2 years); assigned female at birth (46%); cisgender (91%); transgender (5%); White/Caucasian (57%); African American/Black (32%); Hispanic/Latinx (20%); and from Southern states (45%). Most respondents (84%) described a small oral pill as good/very good, decreasing to 66% if the pill was described as large. Most participants described good/very good PrEP administration frequencies of once per year, twice per year, every 2 months (75% for each), and once per week (72%), decreasing to 50% for daily administration. Share of preference estimations for PrEP options with combined attributes were as follows: 47% of respondents preferred a small daily pill, 30% twice-yearly subcutaneous injections, 17% bi-monthly intramuscular injections, and 5% none of these options; preferences were similar in all PrEP-use subpopulations (Figure).
CONCLUSIONS: These results demonstrate the importance of PrEP options for PWBP and an unmet need for longer-acting PrEP.
While daily oral PrEP remains an important choice for HIV-1 prevention, additional longer-acting PrEP options are
critical to meet the needs of all PWBP.
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