HIV prevention is not all about HIV – using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection
Abstract Introduction In sub-Saharan Africa, considerable HIV-burden exists among women. Anti-retroviral (ARV) based prevention products could decrease this burden, and their uptake could be increased if they also protect against pregnancy and sexually transmitted infections (STI). Methods A discret...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-020-05399-4 |
| _version_ | 1818980076332515328 |
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| author | Peter Vickerman Matthew Quaife Maggie Kilbourne-Brook Mercy Mvundura Robyn Eakle Fern Terris-Prestholt |
| author_facet | Peter Vickerman Matthew Quaife Maggie Kilbourne-Brook Mercy Mvundura Robyn Eakle Fern Terris-Prestholt |
| author_sort | Peter Vickerman |
| collection | DOAJ |
| description | Abstract Introduction In sub-Saharan Africa, considerable HIV-burden exists among women. Anti-retroviral (ARV) based prevention products could decrease this burden, and their uptake could be increased if they also protect against pregnancy and sexually transmitted infections (STI). Methods A discrete choice experiment (DCE) was undertaken in South Africa (2015) through a household survey of adult females (n = 158) and adolescent girls (n = 204) who self-reported HIV-negative status. The DCE was used to project the uptake (percentage using product) of oral pre-exposure prophylaxis (PrEP), vaginal rings, and injectable long-lasting ARV agents among these women, and how uptake could depend on whether these products protect against pregnancy or STI acquisition. Uptake estimates were used to model how each product could decrease a women’s HIV acquisition risk. Results In adolescent women, there will be limited uptake (< 6% for any product) and impact (< 4% decrease in HIV acquisition risk) of new products unless they provide pregnancy protection, which could quadruple use and impact. Adult women have weaker preference for pregnancy protection, with moderate use (< 17% for each) and impact (< 14 percentage point decrease) if they only provide HIV protection. All women had highest preference for injectable ARVs, with oral PrEP having high preference if injectable ARVs are not available. Adult women will use the ring, but adolescent women will not. Importantly, even with three additional prevention products, all providing pregnancy and STI protection, > 14% of women will remain unprotected and > 31% of the baseline acquisition risk will remain. Conclusions Incorporating multiple prevention components into new ARV-based prevention products may increase their uptake and impact among women. |
| first_indexed | 2024-12-20T17:09:40Z |
| format | Article |
| id | doaj.art-8432220e83d3464891eeb58b2bc23333 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-20T17:09:40Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-8432220e83d3464891eeb58b2bc233332022-12-21T19:32:11ZengBMCBMC Infectious Diseases1471-23342020-09-0120111110.1186/s12879-020-05399-4HIV prevention is not all about HIV – using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protectionPeter Vickerman0Matthew Quaife1Maggie Kilbourne-Brook2Mercy Mvundura3Robyn Eakle4Fern Terris-Prestholt5Population Health Sciences, University of BristolLondon School of Hygiene and Tropical MedicinePATHPATHLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineAbstract Introduction In sub-Saharan Africa, considerable HIV-burden exists among women. Anti-retroviral (ARV) based prevention products could decrease this burden, and their uptake could be increased if they also protect against pregnancy and sexually transmitted infections (STI). Methods A discrete choice experiment (DCE) was undertaken in South Africa (2015) through a household survey of adult females (n = 158) and adolescent girls (n = 204) who self-reported HIV-negative status. The DCE was used to project the uptake (percentage using product) of oral pre-exposure prophylaxis (PrEP), vaginal rings, and injectable long-lasting ARV agents among these women, and how uptake could depend on whether these products protect against pregnancy or STI acquisition. Uptake estimates were used to model how each product could decrease a women’s HIV acquisition risk. Results In adolescent women, there will be limited uptake (< 6% for any product) and impact (< 4% decrease in HIV acquisition risk) of new products unless they provide pregnancy protection, which could quadruple use and impact. Adult women have weaker preference for pregnancy protection, with moderate use (< 17% for each) and impact (< 14 percentage point decrease) if they only provide HIV protection. All women had highest preference for injectable ARVs, with oral PrEP having high preference if injectable ARVs are not available. Adult women will use the ring, but adolescent women will not. Importantly, even with three additional prevention products, all providing pregnancy and STI protection, > 14% of women will remain unprotected and > 31% of the baseline acquisition risk will remain. Conclusions Incorporating multiple prevention components into new ARV-based prevention products may increase their uptake and impact among women.http://link.springer.com/article/10.1186/s12879-020-05399-4HIVSouth AfricaWomenPre-exposure prophylaxisVaginal ringInjectable long-lasting ARV agents |
| spellingShingle | Peter Vickerman Matthew Quaife Maggie Kilbourne-Brook Mercy Mvundura Robyn Eakle Fern Terris-Prestholt HIV prevention is not all about HIV – using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection BMC Infectious Diseases HIV South Africa Women Pre-exposure prophylaxis Vaginal ring Injectable long-lasting ARV agents |
| title | HIV prevention is not all about HIV – using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection |
| title_full | HIV prevention is not all about HIV – using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection |
| title_fullStr | HIV prevention is not all about HIV – using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection |
| title_full_unstemmed | HIV prevention is not all about HIV – using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection |
| title_short | HIV prevention is not all about HIV – using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection |
| title_sort | hiv prevention is not all about hiv using a discrete choice experiment among women to model how the uptake and effectiveness of hiv prevention products may also rely on pregnancy and sti protection |
| topic | HIV South Africa Women Pre-exposure prophylaxis Vaginal ring Injectable long-lasting ARV agents |
| url | http://link.springer.com/article/10.1186/s12879-020-05399-4 |
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