The Invisible Product: Preferences for Sustained-Release, Long-Acting Pre-exposure Prophylaxis to HIV Among South African Youth
The Invisible Product: Preferences for Sustained-Release, Long-Acting Pre-exposure Prophylaxis to HIV Among South African Youth
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DOI：
10.1097/qai.0000000000001960
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发表时间：
2019-04-15
影响因子：
3.6
通讯作者：
Minnis, Alexandra M.
中科院分区：
文献类型：
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作者：
Montgomery, Elizabeth T.;Atujuna, Millicent;Minnis, Alexandra M.
背景：长效注射和植入性方法旨在通过吸收和遵守当前的艾滋病毒预防方法来克服一些有文献记载的挑战。年轻人是这些方法的关键最终用户群体。方法：95名年龄在18-24岁的南非青年，其中62名为女性，33名为男性，完成了50次访谈和6个焦点小组。我们有目的地选择以前的产品经验，包括口服暴露前预防、可注射暴露前预防或阴道环，以确保参与者的意见植根于实际经验。结果：无论以前的方法使用经验、性别或性取向如何，大多数人都表示倾向于使用注射剂或植入物的预防方法。一些人提到，他们在任何产品中都最优先考虑的是疗效，对一些人来说，这一点凌驾于其他担忧之上；例如，即使他们害怕疼痛，如果完全保护，植入物或注射剂也会被使用。尽管功效是重中之重，但所有亚组也都有明显的愿望，希望产品不会干预性行为，留在系统中提供保护，并且造成的负担最小，或者对其他人来说不明显，这些特征在长效方法中最为突出。结论：对偏好的叙述性解释围绕着对自己、伴侣和家庭成员以及社区成员看不见的不同维度进行主题融合。终端用户的偏好可用于通知产品开发长效艾滋病毒预防方法，如注射或植入物，以优化依从性和影响。
Background: Long-acting injectable and implantable approaches aim to overcome some of the documented challenges with uptake and adherence to current HIV prevention methods. Youth are a key end-user population for these methods. We used qualitative methods to examine product attributes and preferences for current and future long-acting HIV prevention approaches.Methods: Ninety-five South African youth aged 18-24 years, of whom 62 were female and 33 male, completed 50 interviews and 6 focus groups. We purposively selected for previous product experience, including oral pre-exposure prophylaxis, injectable pre-exposure prophylaxis, or the vaginal ring, to ensure participants' opinions were rooted in actual experience.Results: Irrespective of previous method-use experience, gender, or sexual orientation, the majority expressed a preference for prevention methods formulated as injectables or implants. Several mentioned that their top priority in any product was efficacy, and for some, this overrode other concerns; for example, even if they feared pain, an implant or an injectable would be used if fully protective. Although efficacy was a top priority, there was also a clear desire across all subgroups for a product that would not interfere with sex, would stay in the system to provide protection, and that caused minimal burden, or was not apparent to others, and these characteristics were most salient for long-acting methods.Conclusions: Narrative explanations for preferences converged thematically around different dimensions of "invisibility" including invisibility to oneself, one's partner and household members, and community members. End-user preferences can be used to inform product development of long-acting HIV prevention approaches formulated as injections or implants to optimize adherence and impact.