Study Aim: To understand preferences for potential pre-exposure prophylaxis (PrEP) implementation models for AGYW aged 15-24 who currently or have recently been at risk for HIV in the Shinyanga and Mwanza regions of Tanzania.
Background:
- Numerous studies have documented socio-cultural barriers for uptake and adherence to PrEP among AGYW in East Africa. Yet AGYW remain disproportionately affected by HIV transmission. Newer modalities of PrEP (injectables, vaginal ring) show promise in addressing some of these barriers, however understanding the preferences of AGYW in terms of accessing these modalities is crucial to ensuring their uptake.
- Discrete choice experiments are a quantitative technique which aims to elicit user preferences over a defined choice set, a technique often employed in the health policy and planning arena. Asking users their preferences via more traditional avenues, such as ranking or rating, often fails to accurately predict revealed preferences (i.e., true) respondents have when selecting from many choices, which then limits researchers’ ability to draw meaningful and clear conclusions about consumer demand. DCEs offer a number of hypothetical options (presented as a series of paired options/choice sets), known as attributes, and through the selected responses allows the researcher to understand which specific attributes are valued over others. This is preferred when there are multiple attributes and when the attributes have different attribute levels (e.g., different prices, different healthcare locations) which are to be evaluated together.
- The DCE will evaluate AGYW preferences over a number of potential attributes and levels based on some of the known and documented barriers to PrEP uptake, such as screening and refill locations, provider characteristics, and different PrEP modalities. We will use Sawtooth software, provided by UCSF CFAR, to program the DCE.
Inclusion Criteria: AGYW (aged 15-24) who screen as currently or recently eligible for PrEP using the Tanzanian PrEP Screener will be eligible to enroll in this study. We aim to enroll 700 AGYW.
Timeline: Formative research occurred from July-October, 2022. Data collection began in March 2023 and will be completed in June 2023. Data analysis is planned from June-September 2023
Funder: UCSF Center for AIDS Research BOOST