Identifying HIV PrEP Attributes to Increase PrEP Use Among Different Groups of Gay, Bisexual, and Other Men Who Have Sex with Men: A Latent Class Analysis of a Discrete Choice Experiment.
Rahel Dawit, Zachary Predmore, Julia Raifman, Philip A Chan, Alexandra Skinner, Siena Napoleon, Alexandra Zanowick-Marr, Danielle Le Brazidec, Alexi Almonte, Lorraine T Dean
Author Information
Rahel Dawit: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA. rdawit1@jhu.edu. ORCID
Zachary Predmore: RAND Health Care, RAND Corporation, Boston, MA, 02116, USA.
Julia Raifman: Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, 02118, USA.
Philip A Chan: Brown University AIDS Program, The Miriam Hospital, Providence, RI, 02906, USA.
Alexandra Skinner: Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, 02118, USA.
Siena Napoleon: Brown University AIDS Program, The Miriam Hospital, Providence, RI, 02906, USA.
Alexandra Zanowick-Marr: Brown University AIDS Program, The Miriam Hospital, Providence, RI, 02906, USA.
Danielle Le Brazidec: Brown University AIDS Program, The Miriam Hospital, Providence, RI, 02906, USA.
Alexi Almonte: Brown University AIDS Program, The Miriam Hospital, Providence, RI, 02906, USA.
Lorraine T Dean: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
Daily pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV among gay, bisexual, and other men who have sex with men (GBMSM), although uptake remains suboptimal. By identifying the features of PrEP that appeal to various subgroups of GBMSM, this study aimed to improve PrEP uptake by examining preferences for PrEP use. Adults���������18 years old in six New England states completed an online discrete choice experiment survey. A latent class analysis (LCA) was conducted to identify groups of GBMSM based on four attributes of choices for PrEP (cost, time, side effects, and mode of administration). Multinominal logistic regression was conducted to compare the association between sociodemographic and behavioral characteristics and class memberships. Data from 675 GBMSM were analyzed. A 3-Class model was selected as the best fit model. Class 1 (47.7% of individuals) was identified as having "no specific preferences". Class 2 (18.5% of individuals) were "Cost- and time-conscious" and were significantly more likely to be older, have prior sexually transmitted infection (STI) testing, have low household income, private insurance, and have extreme concerns about HIV risk than those with no specific preference (Class 1). Finally, Class 3 (34.1% of individuals) were "Side effects-conscious" and were more likely to have low income, private insurance, and have moderate and extreme concerns about HIV risk than those with no specific preference (Class 1). Findings indicate that outreach to GBMSM who have never used PrEP should emphasize low cost and short travel times to increase potential PrEP use.
