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

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 ( 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.

Keywords

• HIV
• South Africa
• Women
• Pre-exposure prophylaxis
• Vaginal ring
• Injectable long-lasting ARV agents