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What do women prefer in a vaginal HIV prevention product? Findings From a discrete choice experiment in Southern Africa
Browne, E., Montgomery, E., van der Straten, A., Boeri, M., Mange, B., Beksinska, M., Schwartz, J., Clark, M., Doncel, G., Smit, J., Chirenje, Z. M., & Mansfield, C. (2018). What do women prefer in a vaginal HIV prevention product? Findings From a discrete choice experiment in Southern Africa. AIDS Research and Human Retroviruses, 34(S1), 158. https://doi.org/10.1089/aid.2018.5000.abstracts
Meeting Abstract: P03.48 Background: As new female-initiated HIV prevention products enter development, it is crucial to incorporate women‘s preferences to ensure products will be desired, accepted and used. A discrete choice experiment (DCE) was designed to identify preferred features of a vaginally-delivered HIV prevention product. Methods: The DCE survey was conducted among sexually active women aged 18-30 in Durban, South Africa and Harare, Zimbabwe. Participants were from two samples: product-experienced women from a randomized trial of four vaginal placebo forms (QUATRO) and product-naïve community members. In a tablet-self-administered survey, women were asked to choose between two hypothetical intravaginal HIV prevention products over 8 choice sets. Alternative designs were characterized by six attributes: HIV prevention efficacy (30%, 50%, 80%), pregnancy prevention, dosage (before sex, after sex, daily, monthly), mode of insertion (finger, applicator), wetness (none, some, a lot), and partner awareness during sex. Preference weights and relative importance scores were estimated using random-parameters logit. Results: In total, 395 women completed the survey (56% productnaïve). Median age was 24 (IQR 21-26), 97% had a primary partner, and 69% had completed secondary school. Preferences did not vary by sample (p>0.90). HIV protection was the most important attribute, dominating stated choice. Yet, there were identifiable preferences among other features. Women preferred a product which also prevented pregnancy and caused some vaginal wetness (p< 0.001). They disliked a product that needs to be used every day (p=0.003), with no significant preference for other timing. A reusable applicator was favored to insertion by finger (p=0.001). Partner awareness was not a significant factor when choosing a product (p=0.09). Conclusions: Efficacy was the most important attribute. However, features such as wetness and dosing may influence preference; there may be interest in a multipurpose product that also prevents pregnancy. P03
