scholarly journals Preferences regarding emerging HIV prevention technologies among Toronto men who have sex with men: a discrete choice experiment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Darrell H. S. Tan ◽  
Jayoti Rana ◽  
Zavare Tengra ◽  
Trevor A. Hart ◽  
James Wilton ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Hiv Prevention ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Marginal Rate ◽  
On Demand ◽  
Marginal Rate Of Substitution ◽  
Sex With Men ◽  
Long Acting

AbstractNew forms of HIV pre-exposure prophylaxis (PrEP) include long-acting injectables and topical microbicides, each with unique attributes that may appeal to distinct users. We used a discrete choice experiment to characterize preferences for new PrEP formulations among Toronto men who have sex with men. MSM undergoing anonymous HIV testing completed a discrete choice experiment with 12 choice sets by selecting their preferred option within each set. Each set included “usual methods to prevent HIV” (excluding PrEP) as one alternative and two hypothetical PrEP alternatives, which differed according formulation/dosing, side effects (none/mild), risk of drug resistance (none/low/moderate), and HIV prevention efficacy (50%, 65%, 80% or 99% risk reduction). We used mixed logistic regression to infer preferences for PrEP attributes and calculate the marginal rate of substitution between efficacy and other PrEP attributes. 306 men with median (interquartile range) age = 29 (25, 36) years participated, and reported 6 (3, 10) partners and 0 (0, 2) condomless receptive anal sex acts in the preceding six months. An on-demand pill was the most preferred formulation, followed by a monthly injection, daily pill, and on-demand rectal gel. Drug resistance was an important determinant of preferences if the risk was moderate, but not if it was low. The minimum efficacy required for an on-demand pill to be preferred over no PrEP was 32.6% (95%CI = 21.2–43.9%); for a daily pill, injections, and rectal gel, minimum efficacy was 57.9% (95%CI = 44.1–71.7%), 40.1% (27.0–53.2%), and 71.3% (60.5–82.1%), respectively. Attitudes towards PrEP formulations vary among men who have sex with men, with on-demand pills and monthly injections having the highest average preference scores. Understanding these preferences may help to predict uptake.

scholarly journals The Usefulness of the Discrete Choice Experiment in Providing Effective Healthcare

2014 ◽  
Vol 10 (4) ◽  
Author(s):  
Nikolina Dukić
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Economic Value ◽  
Public Health Care ◽  
Economic Evaluations ◽  
Public Healthcare ◽  
Healthcare Intervention ◽  
Marginal Rate ◽  
Marginal Rate Of Substitution

Given that in times of crisis the burden of chronic disease is increasing, preventive interventions are becoming more important as they affect the maintenance and improvement of the population’s health, therefore reducing government spending on the sick leave and disability benefits. As public healthcare is characterized by administrative decision-making and relying on non-market mechanisms in the resource allocation, it requires the implementation of economic evaluations. This discussion shows that because the specifics of public healthcare complicate the data collection of revealed (market) preferences, it is necessary to rely on stated preferences of respondents in order to evaluate the economic value of health interventions as well to improve public health care interventions and make them more patients oriented. Also, this article explores the method of discrete choice experiment along with its applications in healthcare, which seeks to identify the marginal rate of substitution between relevant attributes of public healthcare intervention and its impact on the patients’ choice, hence enabling a broad application of the method.

The Systematic Development of Attributes And Levels For A Discrete Choice Experiment of HIV Patient Preferences For Long-Acting Antiretroviral Therapies In The United States

2021 ◽  
Author(s):  
Aaron T. Brah ◽  
Douglas Barthold ◽  
Brett Hauber ◽  
Ann C. Collier ◽  
Rodney J.Y. Ho ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Treatment Time ◽  
Negative Reaction ◽  
Antiretroviral Therapies ◽  
Key Informant ◽  
Pre Treatment ◽  
Long Acting

Abstract Introduction: Patient preferences for long-acting antiretroviral therapies (LA-ART) should inform development of regimens with optimal adherence and acceptability. We describe a systematic process used to identify attributes and levels for a discrete choice experiment (DCE) designed to elicit preferences for potential LA-ART options in the US. Methods: Our approach was conducted in four stages: data collection, data reduction, removing inappropriate attributes, and optimizing wording. We started with 8 attributes defining potential LA-ART products based on existing literature and knowledge of products in development. We conducted 12 key informant interviews with experts in HIV treatment. The list of attributes, the set of plausible levels for each attribute, and restrictions on combinations of attribute levels were updated iteratively.Results: Despite uncertainty about which products will become available, key informant discussions converged on 4 delivery modes (infusions and patches were not considered immediately feasible) and 6 additional attributes. Treatment effectiveness and frequency of clinical monitoring were dropped. Oral lead-in therapy was split into two attributes: pre-treatment time undetectable and pre-treatment negative reaction testing. We omitted product-specific systemic and local side effects. In addition to mode, the final set of attributes included: frequency of dosing; location of treatment; pain; pre-treatment time undetectable; pre-treatment negative reaction testing; and late-dose leeway.Conclusions: A systematic process successfully captured elements that are both feasible and relevant to evaluating the acceptability of potential LA-ART alternatives to patients.

scholarly journals Designing a brief behaviour change intervention to reduce sexually transmitted infections: a discrete choice experiment

2018 ◽  
Vol 29 (9) ◽  
pp. 851-860 ◽  
Author(s):  
Alec Miners ◽  
Carrie Llewellyn ◽  
Carina King ◽  
Alex Pollard ◽  
Anupama Roy ◽  
...  
Keyword(s):  
Health Care ◽  
Sexually Transmitted Infections ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Important Determinant ◽  
Behavioural Change ◽  
Behaviour Change Intervention ◽  
Sexually Transmitted ◽  
Sex With Men

To understand whether people attending sexual health (SH) clinics are willing to participate in a brief behavioural change intervention (BBCI) to reduce the likelihood of future sexually transmitted infections (STIs) and to understand their preferences for different service designs, we conducted a discrete choice experiment (DCE) with young heterosexual adults (aged 16–25 years), and men who have sex with men (MSM) aged 16 or above, attending SH clinics in England. Data from 368 participants showed that people particularly valued BBCIs that involved talking (OR 1.45; 95%CI 1.35, 1.57 compared with an ‘email or text’-based BBCIs), preferably with a health care professional rather than a peer. Findings also showed that 26% of respondents preferred ‘email/texts’ to all other options; the remaining 14% preferred not to participate in any of the offered BBCIs. These results suggest that most people attending SH clinics in England are likely to participate in a BBCI if offered, but the type/format of the BBCI is likely to be the single important determinant of uptake rather than characteristics such as the length and the number of sessions. Moreover, participants generally favoured ‘talking’-based options rather than digital alternatives, which are likely to require the most resources to implement.

scholarly journals How Much Demand for New HIV Prevention Technologies Can We Really Expect? Results from a Discrete Choice Experiment in South Africa

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e83193 ◽  
Author(s):  
Fern Terris-Prestholt ◽  
Kara Hanson ◽  
Catherine MacPhail ◽  
Peter Vickerman ◽  
Helen Rees ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment

scholarly journals Preferences for HIV testing services among men who have sex with men in the UK: A discrete choice experiment

PLoS Medicine ◽  
2019 ◽  
Vol 16 (4) ◽  
pp. e1002779 ◽  
Author(s):  
Alec Miners ◽  
Tom Nadarzynski ◽  
Charles Witzel ◽  
Andrew N. Phillips ◽  
Valentina Cambiano ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Hiv Testing Services ◽  
Sex With Men ◽  
The Uk
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