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Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment

Men who have sex with men (MSM) in Malaysia are disproportionately affected by HIV. As pre-exposure prophylaxis (PrEP) is being introduced, we assessed population-based PrEP delivery preferences among MSM in Malaysia. We conducted a discrete choice experiment through an online survey among 718 MSM....

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Autores principales: Dubov, Alex, Altice, Frederick L., Gutierrez, José I., Wickersham, Jeffrey A., Azwa, Iskandar, Kamarulzaman, Adeeba, Gautam, Kamal, Shrestha, Roman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468492/
https://www.ncbi.nlm.nih.gov/pubmed/37648731
http://dx.doi.org/10.1038/s41598-023-41264-5
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author Dubov, Alex
Altice, Frederick L.
Gutierrez, José I.
Wickersham, Jeffrey A.
Azwa, Iskandar
Kamarulzaman, Adeeba
Gautam, Kamal
Shrestha, Roman
author_facet Dubov, Alex
Altice, Frederick L.
Gutierrez, José I.
Wickersham, Jeffrey A.
Azwa, Iskandar
Kamarulzaman, Adeeba
Gautam, Kamal
Shrestha, Roman
author_sort Dubov, Alex
collection PubMed
description Men who have sex with men (MSM) in Malaysia are disproportionately affected by HIV. As pre-exposure prophylaxis (PrEP) is being introduced, we assessed population-based PrEP delivery preferences among MSM in Malaysia. We conducted a discrete choice experiment through an online survey among 718 MSM. The survey included 14 choice tasks presenting experimentally varied combinations of five attributes related to PrEP delivery (i.e., cost, dosing strategy, clinician interaction strategy, dispensing venue, and burden of visits to start PrEP). We used latent class analysis and Hierarchical Bayesian modeling to generate the relative importance of each attribute and preference across six possible PrEP delivery programs. PrEP dosing, followed by cost, was the most important attribute. The participants were clustered into five preference groups. Two groups (n = 290) most commonly preferred on-demand, while the other three preferred injectable PrEP. One group (n = 188) almost exclusively considered cost in their decision-making, and the smallest group (n = 86) was substantially less interested in PrEP for reasons unrelated to access. In simulated scenarios, PrEP initiation rates varied by the type of program available to 55·0% of MSM. Successful PrEP uptake among Malaysian MSM requires expanding beyond daily oral PrEP to on-demand and long-acting injectable PrEP, especially at affordable cost.
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spelling pubmed-104684922023-09-01 Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment Dubov, Alex Altice, Frederick L. Gutierrez, José I. Wickersham, Jeffrey A. Azwa, Iskandar Kamarulzaman, Adeeba Gautam, Kamal Shrestha, Roman Sci Rep Article Men who have sex with men (MSM) in Malaysia are disproportionately affected by HIV. As pre-exposure prophylaxis (PrEP) is being introduced, we assessed population-based PrEP delivery preferences among MSM in Malaysia. We conducted a discrete choice experiment through an online survey among 718 MSM. The survey included 14 choice tasks presenting experimentally varied combinations of five attributes related to PrEP delivery (i.e., cost, dosing strategy, clinician interaction strategy, dispensing venue, and burden of visits to start PrEP). We used latent class analysis and Hierarchical Bayesian modeling to generate the relative importance of each attribute and preference across six possible PrEP delivery programs. PrEP dosing, followed by cost, was the most important attribute. The participants were clustered into five preference groups. Two groups (n = 290) most commonly preferred on-demand, while the other three preferred injectable PrEP. One group (n = 188) almost exclusively considered cost in their decision-making, and the smallest group (n = 86) was substantially less interested in PrEP for reasons unrelated to access. In simulated scenarios, PrEP initiation rates varied by the type of program available to 55·0% of MSM. Successful PrEP uptake among Malaysian MSM requires expanding beyond daily oral PrEP to on-demand and long-acting injectable PrEP, especially at affordable cost. Nature Publishing Group UK 2023-08-30 /pmc/articles/PMC10468492/ /pubmed/37648731 http://dx.doi.org/10.1038/s41598-023-41264-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Dubov, Alex
Altice, Frederick L.
Gutierrez, José I.
Wickersham, Jeffrey A.
Azwa, Iskandar
Kamarulzaman, Adeeba
Gautam, Kamal
Shrestha, Roman
Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment
title Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment
title_full Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment
title_fullStr Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment
title_full_unstemmed Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment
title_short Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment
title_sort pre-exposure prophylaxis service among men who have sex with men in malaysia: findings from a discrete choice experiment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468492/
https://www.ncbi.nlm.nih.gov/pubmed/37648731
http://dx.doi.org/10.1038/s41598-023-41264-5
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