Survey Reveals Injectable HIV PrEP Preferences of Young Men Who Have Sex With Men

Young men who have sex with men (YMSM) said the treatment’s efficacy was the most important feature injectable HIV pre-exposure prophylaxis (PrEP), over side effects, cost, protection duration, and delivery method.

When considering certain features of injectable HIV pre-exposure prophylaxis (PrEP), young men who have sex with men (YMSM) said the treatment’s efficacy was the most important factor determining whether they would choose injectable PrEP over daily oral PrEP.

This finding was based on results of an online survey completed by 150 YMSM without HIV between October 2020 and June 2021. All participants were cisgender male and aged between 15 and 24 years.

The survey found HIV prevention efficacy was the most important feature of a PrEP injectable, with 42.1% importance among 5 options.

This percentage was much higher than those of 4 other factors. Side effects were the second most important feature at 22.9%, followed by cost (17.8%), duration of protection (13.7%), and mode of delivery (3.6%).

These findings were published in an abstract on injectable PrEP preferences among YMSM in the United States, which was presented at the AIDS 2022 conference, held July 29 to August 2 in Montreal, Canada, and virtually.

To come to these findings, the authors asked participants to choose between random sets of product profiles using the following features:

  • delivery (provider vs self-injected)
  • duration of protection in months (1, 2, 4, 6, 12)
  • HIV prevention efficacy (50%, 65%, 80%, 95%, 99%)
  • potential side effects (none, soreness at injection site, fever, fatigue, nausea, weight gain)
  • monthly cost ($0, $25, $50, $100, $150)

After completing the survey, 10 participants also completed a follow-up in-depth-interview to discuss their product preferences.

Responses were used to estimate YMSM's willingness to pay for the injectable option, considering trade-offs between features.

Participant willingness to pay more than $100 per month was driven by 3 major considerations:

  • achieving at least 80% efficacy ($170.70)
  • having 12 months of protection ($122.70)
  • avoiding weight gain (-$132.50)

The participants' general acceptability of an HIV PrEP injectable was based on those 3 features, personal considerations such as their relationship status or income, and context, taking into account HIV care access and stigma.

Additionally, while PrEP delivery was ranked lowest in importance, these interviews revealed a preference for the injectable delivery method over the oral pill.

One participant said if the price, efficacy, and safety were all the same between the injectable and oral HIV PrEP options, he would choose the injectable option.

Another participant said injectable PrEP was more appealing because it eliminated the need to take daily PrEP pills.

“So, it sounds to me like [injectable PrEP] is a really great way to avoid needing to take a pill daily, perhaps, or any pills whatsoever, for that matter, and still have the HIV protection and prevention that we-you have to come to expect out of these drugs, and also protect you for a longer period of time,” he said.

Reference

Bauermeister J, Drab R, Valente P, et al. A conjoint analysis of injectable PrEP preferences among young sexual minority men. Presented at: AIDS 2022; July 29-August 2, 2022; Montreal, Canada. Abstract 10264.