Efficacy is Not Everything: Eliciting Women’s Preferences for a Vaginal HIV Prevention Product Using a Discrete-Choice Experiment

• DOI: 10.1007/s10461-019-02715-1
• Publication Date: 2019-11-06T19:03:41Z
• Authors: Erica N. Browne; Elizabeth T. Mont...; Carol Mansfield; Marco Boeri; Brennan Mange; Mags Beksinska; Jill L. Schwartz; Meredith R. Clark; Gustavo F. Doncel; Jenni Smit; Zvavahera M. Chir...; Ariane van der St...
• Keywords: Alternative medicine; Economics; Health Professions; Social Sciences; HIV Infections; Reproductive health and childbirth; FOS: Health sciences; Choice Behavior; Contraceptive Use; South Africa; 0302 clinical medicine; Sociology; 5. Gender equality; Pregnancy; Surveys and Questionnaires; /dk/atira/pure/subjectarea/asjc/2700/2725; Pathology; Microeconomics; Psychology; Product (mathematics); Public health; Patient Preference; /dk/atira/pure/subjectarea/asjc/2700/2739; name=Infectious Diseases; Health services; FOS: Sociology; 3. Good health; FOS: Psychology; Economics, Econometrics and Finance; Infectious Diseases; Environmental health; 6.1 Pharmaceuticals; Vagina; General Health Professions; Public Health and Health Services; /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being; HIV/AIDS; Medicine; Female; Public Health; Microbicides for sexually transmitted diseases; Adult; Zimbabwe; Social Work; Economics and Econometrics; Adolescent; Clinical Trials and Supportive Activities; HIV prevention; Population; Discrete Choice Models in Economics and Health Care; 610; Geometry; Nursing; Preference; Young Adult; 03 medical and health sciences; Preference Elicitation; name=Public Health; Clinical Research; Behavioral and Social Science; Health Sciences; FOS: Mathematics; Genetics; Humans; Women; Discrete Choice Models; Biology; Placebo; Demography; Original Paper; Prevention and Treatment of HIV/AIDS Infection; /dk/atira/pure/subjectarea/asjc/3200/3207; Prevention; Contraception/Reproduction; Environmental and Occupational Health; Discrete-choice experiment; Vaginal microbicide; name=SDG 3 - Good Health and Well-being; Health psychology; Stated Preference Methods; FOS: Biological sciences; name=Social Psychology; Women's Health; Sexually Transmitted Infections; Adolescent Sexual Health and Behavior Patterns; Mathematics

Abstract 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 was designed to assess the relative importance of six attributes to stated choice of a vaginally delivered HIV prevention product. Sexually active women in South Africa and Zimbabwe aged 18–30 were recruited from two samples: product-experienced women from a randomized trial of four vaginal placebo forms and product-naïve community members. In a tablet-administered survey, 395 women chose between two hypothetical products over eight choice sets. Efficacy was the most important, but there were identifiable preferences among other attributes. Women preferred a product that also prevented pregnancy and caused some wetness (p < 0.001). They disliked a daily-use product (p = 0.002) and insertion by finger (p = 0.002). Although efficacy drove preference, wetness, pregnancy prevention, and dosing regimen were influential to stated choice of a product, and women were willing to trade some level of efficacy to have other more desired attributes.