Wednesday, May 18, 2011

Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations

IRMA Steering Committee member Jerome T. Galea is lead author of this fascinating paper. Here he provides an overview of the study.

Click here to access the full paper.

"The study examined pre-exposure prophylaxis acceptability (PrEP) among female sex workers, male-to-female transgendered persons and men who have sex with men in Lima, Peru.  Focus groups explored social issues associated with PrEP acceptability and Conjoint Analysis – a consumer research market technique – assessed the preferences participants had with regards to eight hypothetical PrEP “scenarios”.  This was the first study of it's kind to apply this technique.

"Each scenario was made up of the same characteristics but differed slightly (for example, higher cost versus lower cost; daily dosing versus non-daily dosing; some side effects versus no side effects, and so on).  Participants had to rank the scenarios in order of preference taking into account all of the product’s chacteristics, and in doing so expressed the value they placed on the various characteristics.  Focus groups helped to explain the reasons behind the preferences made.

"There were some unexpected findings. For example, cost trumped effectiveness; a low-out-of pocket cost had the single greatest impact on PrEP acceptability. While we expected cost to be an important factor we were surprised that it was more important than the ability of the product to actually prevent HIV infection. 

"Another surprise was that in the focus groups we learned that participants preferred that PrEP be dispensed in health centers as opposed to pharmacies. This surprised us as we hypothesized that pharmacies would provide faster, easier and more widespread access, but participants cited privacy concerns with PrEP being dispensed by pharmacies.

"The next step is to replicate this sort of research to more populations at risk in different settings. We have learned that the existence of an effective product does not guarantee its use (recent studies on the female condom, for example, highlight the challenges of understanding the needs and perceptions of the target user and also the necessity of dispelling myths that often arise when new products are introduced). 

"We cannot generalize our findings to all persons at risk for HIV, in Peru or elsewhere, but do propose it as a model for future exploration of the topic now that oral PrEP has been shown to work but has not yet been scaled up for widespread use."

*Read AIDSmeds coverage of this study here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

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