Preferences for pre-exposure prophylaxis (PrEP) among sexual and gender minorities: a discrete choice experiment in Brazil

Men who have sex with men (MSM) and transgender women (TGW) are disproportionally affected by HIV infection in Latin America. This study aims to assess pre-exposure prophylaxis (PrEP) preferences among sexual and gender minorities (SGM) and identify attributes and levels that are related to PrEP upt...

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Published in:Lancet Regional Health - Americas (Online) 2023-03, Vol.19, p.100432-100432, Article 100432
Main Authors: Pereira, Claudia Cristina de Aguiar, Torres, Thiago Silva, Luz, Paula Mendes, Hoagland, Brenda, Farias, Alessandro, Brito, José David Urbaez, Lacerda, Marcus Vinícius Guimarães, Silva, Daila Alena Raenck, Benedetti, Marcos, Pimenta, Maria Cristina, Grinsztejn, Beatriz, Veloso, Valdilea Gonçalves
Format: Article
Language:English
Subjects:
Human immunodeficiency virus
Injectable PrEP
Latin America
LGBTQIA+
Men who have sex with men
Pre-exposure prophylaxis
PrEP preferences
Sexual and gender minorities
Transgender women
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Summary:Men who have sex with men (MSM) and transgender women (TGW) are disproportionally affected by HIV infection in Latin America. This study aims to assess pre-exposure prophylaxis (PrEP) preferences among sexual and gender minorities (SGM) and identify attributes and levels that are related to PrEP uptake and adherence, both crucial for PrEP success. We conducted a discrete choice experiment (DCE) among SGM from all Brazilian regions (September–December/2020). The survey was administered face-to-face (five Brazilian capitals) and online (entire country). We used a D-efficient zero-prior blocked experimental design to select 60 paired-profile DCE choice tasks. The total sample size was 3924 (90.5% MSM; 7.2% TGW and 2.3% non-binary or gender diverse persons). In random-effects logit models, highest levels of protection and “no side effects” were the most important attribute levels. For “presentation”, injectable and implant were preferred over oral. Participants were willing to accept a 4.1% protection reduction to receive injectable PrEP or a 4.2% reduction if PrEP were taken monthly. The largest class in the latent class models was defined predominantly by the preference for the highest HIV protection level (p 
ISSN:2667-193X
2667-193X
DOI:10.1016/j.lana.2023.100432