Attitudes and Acceptance of Oral and Parenteral HIV Preexposure Prophylaxis among Potential User Groups: A Multinational Study

Abstract

BackgroundThe use of antiviral medications by HIV negative people to prevent acquisition of HIV or pre-exposure prophylaxis (PrEP) has shown promising results in recent trials. To understand the potential impact of PrEP for HIV prevention, in addition to efficacy data, we need to understand both the acceptability of PrEP among members of potential user groups and the factors likely to determine uptake.Methods and findingsSurveys of willingness to use PrEP products were conducted with 1,790 members of potential user groups (FSWs, MSM, IDUs, SDCs and young women) in seven countries: Peru, Ukraine, India, Kenya, Botswana, Uganda and South Africa. Analyses of variance were used to assess levels of acceptance across different user groups and countries. Conjoint analysis was used to examine the attitudes and preferences towards hypothetical and known attributes of PrEP programs and medications. Overall, members of potential user groups were willing to consider taking PrEP (61% reported that they would definitely use PrEP). Current results demonstrate that key user groups in different countries perceived PrEP as giving them new possibilities in their lives and would consider using it as soon as it becomes available. These results were maintained when subjects were reminded of potential side effects, the need to combine condom use with PrEP, and for regular HIV testing. Across populations, route of administration was considered the most important attribute of the presented alternatives.ConclusionsDespite multiple conceivable barriers, there was a general willingness to adopt PrEP in key populations, which suggests that if efficacious and affordable, it could be a useful tool in HIV prevention. There would be a willingness to experience inconvenience and expense at the levels included in the survey. The results suggest that delivery in a long lasting injection would be a good target in drug development.

Acceptability of Oral versus Rectal HIV Preexposure Prophylaxis among Men Who Have Sex with Men and Transgender Women in Peru

“…Although several studies are emerging with regard to the acceptability of oral PrEP in different populations, [14][15][16][17][18] to our knowledge, this is the first to assess the acceptability of oral versus rectal PrEP among MSM and TGW who mainly practice URAI. Importantly, data for this study were collected in 2008, before the results of the iPrEx study were disseminated in 2010, 2 thereby providing a unique opportunity to assess the potential PrEP acceptability when the approach was still hypothetical.…”

Perspectives on HIV Prevention Among Urban Black Women: A Potential Role for HIV Pre-Exposure Prophylaxis

“…Although studies have assessed PrEP acceptability among men who have sex with men, 21,22 men and women in international settings, [23][24][25][26] and high risk heterosexuals in the US, 27,28 there is a critical need to understand PrEP acceptability and product preferences among US black women, [29][30][31][32] given the high HIV incidence in this population. A national survey of adult women in the US found that African American women were more likely than white women to consider using oral PrEP and that cost, peer perspectives, and physician input would influence their decision making.…”

Bispecific antibodies directed to CD4 domain 2 and HIV envelope exhibit exceptional breadth and picomolar potency against HIV-1

“…Abs are generally well tolerated and can be administered infrequently because of their longer half-life in vivo. Indeed, a recent multinational study of potential PrEP users showed that route of administration was the most important attribute regarding acceptability of a PrEP program, with a monthly or bimonthly injection preferred over daily or intermittent pills (17). In addition, numerous studies in macaques have demonstrated that passive immunization with bNAbs can prevent infection by hybrid simian-human immunodeficiency viruses (18)(19)(20)(21).…”