Study reveals young men who have sex with men prefer injectable HIV PrEP

When considering some characteristics of injectable HIV pre-exposure prophylaxis (PrEP), young men who have sex with men (YMSM) said treatment efficacy was the most important factor in whether they would choose injectable PrEP over daily oral PrEP.

This finding is based on results from an online survey completed by 150 HIV-free YMSM between October 2020 and June 2021. All participants were cisgender men and between the ages of 15 and 24.

The study found that HIV prevention efficacy was the most important feature of injectable PrEP, with 42.1% importance among 5 options.

This percentage is much higher than that of 4 other factors. Side effects were the second most important characteristic at 22.9%, followed by price (17.8%), duration of protection (13.7%) and method of delivery (3.6%).

These findings were published in an abstract on PrEP injection preferences among YMSM in the United States, which was presented at the AIDS 2022 conference, held from July 29 to August 2 in Montreal, Canada, and virtually.

To arrive at these findings, the authors asked participants to choose between random sets of product profiles using the following features:

• delivery (supplier vs self-injected)
• duration of protection in months (1, 2, 4, 6, 12)
• HIV prevention effectiveness (50%, 65%, 80%, 95%, 99%)
• potential side effects (none, injection site soreness, fever, fatigue, nausea, weight gain)
• monthly price ($0, $25, $50, $100, $150)

After completing the survey, 10 participants also completed a follow-up in-depth interview to discuss their product preferences.

Responses were used to assess YMSM’s willingness to pay for the injectable option given the trade-off between features.

Participants’ willingness to pay more than $100 per month is driven by 3 main considerations:

• achieving at least 80% efficacy ($170.70)
• with 12 months protection ($122.70)
• avoid weight gain (-$132.50)

Participants’ overall acceptability of injecting HIV PrEP was based on these 3 characteristics, personal considerations such as relationship status or income, and context, taking into account access to HIV care and stigma.

Additionally, while delivery of PrEP was ranked lowest in importance, these interviews revealed a preference for the injectable delivery method over the oral pill.

One participant said that if cost, efficacy, and safety were the same between injectable and oral HIV PrEP options, he would choose the injectable option.

Another participant said that injectable PrEP is more attractive because it eliminates the need to take PrEP pills every day.

“Sounds like [injectable PrEP] is a really great way to avoid having to take a pill every day, maybe, or any pills, for that matter, and still have the HIV protection and prevention that we—you—should expect from these drugs, and also protection for a longer period of time,” he said.

reference

Bauermeister J, Drab R, Valente P, et al. A pooled analysis of PrEP injection preferences among young sexual minority men. Presented at: AIDS 2022; July 29-August 2, 2022; Montreal, Canada. Summary 10264.