Assessing preferences for HIV pre-exposure prophylaxis (PrEP) delivery services via online pharmacies in Kenya: protocol for a discrete choice experiment

Introduction Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition, but coverage remains low in high prevalence settings. Initiating and continuing PrEP via online pharmacies is a promising strategy to expand PrEP uptake but little is known about user preferences for this...

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Main Authors: Melissa Latigo Mugambi, Katrina F Ortblad, Kenneth Ngure, Catherine Kiptinness, Fern Terris-Prestholt, Monisha Sharma, Andy Stergachis, Yilin Chen, Enrique M Saldarriaga, Michalina A Montano, Nicholas Thuo, Maeve Rafferty
Format: Article
Language:English
Published: BMJ Publishing Group 2023-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/4/e069195.full
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author Melissa Latigo Mugambi
Katrina F Ortblad
Kenneth Ngure
Catherine Kiptinness
Fern Terris-Prestholt
Monisha Sharma
Andy Stergachis
Yilin Chen
Enrique M Saldarriaga
Michalina A Montano
Nicholas Thuo
Maeve Rafferty
author_facet Melissa Latigo Mugambi
Katrina F Ortblad
Kenneth Ngure
Catherine Kiptinness
Fern Terris-Prestholt
Monisha Sharma
Andy Stergachis
Yilin Chen
Enrique M Saldarriaga
Michalina A Montano
Nicholas Thuo
Maeve Rafferty
author_sort Melissa Latigo Mugambi
collection DOAJ
description Introduction Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition, but coverage remains low in high prevalence settings. Initiating and continuing PrEP via online pharmacies is a promising strategy to expand PrEP uptake but little is known about user preferences for this strategy. We describe methods for a discrete choice experiment (DCE) to assess preferences for PrEP delivery from an online pharmacy.Methods and analysis This cross-sectional study is conducted in Nairobi, Kenya, in partnership with MYDAWA, a private online pharmacy retailer with a planned sample size of >400 participants. Eligibility criteria are: ≥18 years, not known HIV-positive and interested in PrEP. Initial DCE attributes and levels were developed via literature review and stakeholder meetings. We conducted cognitive interviews to assess participant understanding of the DCE survey and refined the design. The final DCE used a D-efficient design and contained four attributes: PrEP eligibility assessment, HIV test type, clinical consultation type and user support options. Participants are presented with eight scenarios consisting of two hypothetical PrEP delivery services. The survey was piloted among 20 participants before being advertised on the MYDAWA website on pages displaying products indicating HIV risk (eg, HIV self-test kits). Interested participants call a study number and those screened eligible meet a research assistant in a convenient location to complete the survey. The DCE will be analysed using a conditional logit model to assess average preferences and mixed logit and latent class models to evaluate preference heterogeneity among subgroups.Ethics and dissemination This study was approved by the University of Washington Human Research Ethics Committee (STUDY00014011), the Kenya Medical Research Institute, Nairobi County (EOP/NMS/HS/128) and the Scientific and Ethics Review Unit in Kenya (KEMRI/RES/7/3/1). Participation in the DCE is voluntary and subject to completion of an electronic informed consent. Findings will be shared at international conferences and peer-reviewed publications, and via engagement meetings with stakeholders.
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spelling doaj-art-3174007fdf6e4a32929c8a6ba3ef5c092025-08-20T02:49:47ZengBMJ Publishing GroupBMJ Open2044-60552023-04-0113410.1136/bmjopen-2022-069195Assessing preferences for HIV pre-exposure prophylaxis (PrEP) delivery services via online pharmacies in Kenya: protocol for a discrete choice experimentMelissa Latigo Mugambi0Katrina F Ortblad1Kenneth Ngure2Catherine Kiptinness3Fern Terris-Prestholt4Monisha Sharma5Andy Stergachis6Yilin Chen7Enrique M Saldarriaga8Michalina A Montano9Nicholas Thuo10Maeve Rafferty11Department of Global Health, University of Washington, Seattle, Washington, USAPublic Health Science Division, Fred Hutchinson Cancer Center, Seattle, Washington, USACommunity Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, KenyaCenter for Clinical Research, Kenya Medical Research Institute, Nairobi, KenyaWarwick Medical School, University of Warwick, Coventry, UKDepartment of Global Health, University of Washington, Seattle, Washington, USADepartment of Pharmacy, University of Washington School of Public Health, Seattle, Washington, USAThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, ChinaUniversity of Washington, Seattle, Washington, USAVaccine and Infectious Diseases Division (VIDD), Fred Hutchinson Cancer Center, Seattle, Washington, USA1 Family Medicine, Univeristy of Washington, Seattle, WA, USAMYDAWA, Nairobi, KenyaIntroduction Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition, but coverage remains low in high prevalence settings. Initiating and continuing PrEP via online pharmacies is a promising strategy to expand PrEP uptake but little is known about user preferences for this strategy. We describe methods for a discrete choice experiment (DCE) to assess preferences for PrEP delivery from an online pharmacy.Methods and analysis This cross-sectional study is conducted in Nairobi, Kenya, in partnership with MYDAWA, a private online pharmacy retailer with a planned sample size of >400 participants. Eligibility criteria are: ≥18 years, not known HIV-positive and interested in PrEP. Initial DCE attributes and levels were developed via literature review and stakeholder meetings. We conducted cognitive interviews to assess participant understanding of the DCE survey and refined the design. The final DCE used a D-efficient design and contained four attributes: PrEP eligibility assessment, HIV test type, clinical consultation type and user support options. Participants are presented with eight scenarios consisting of two hypothetical PrEP delivery services. The survey was piloted among 20 participants before being advertised on the MYDAWA website on pages displaying products indicating HIV risk (eg, HIV self-test kits). Interested participants call a study number and those screened eligible meet a research assistant in a convenient location to complete the survey. The DCE will be analysed using a conditional logit model to assess average preferences and mixed logit and latent class models to evaluate preference heterogeneity among subgroups.Ethics and dissemination This study was approved by the University of Washington Human Research Ethics Committee (STUDY00014011), the Kenya Medical Research Institute, Nairobi County (EOP/NMS/HS/128) and the Scientific and Ethics Review Unit in Kenya (KEMRI/RES/7/3/1). Participation in the DCE is voluntary and subject to completion of an electronic informed consent. Findings will be shared at international conferences and peer-reviewed publications, and via engagement meetings with stakeholders.https://bmjopen.bmj.com/content/13/4/e069195.full
spellingShingle Melissa Latigo Mugambi
Katrina F Ortblad
Kenneth Ngure
Catherine Kiptinness
Fern Terris-Prestholt
Monisha Sharma
Andy Stergachis
Yilin Chen
Enrique M Saldarriaga
Michalina A Montano
Nicholas Thuo
Maeve Rafferty
Assessing preferences for HIV pre-exposure prophylaxis (PrEP) delivery services via online pharmacies in Kenya: protocol for a discrete choice experiment
BMJ Open
title Assessing preferences for HIV pre-exposure prophylaxis (PrEP) delivery services via online pharmacies in Kenya: protocol for a discrete choice experiment
title_full Assessing preferences for HIV pre-exposure prophylaxis (PrEP) delivery services via online pharmacies in Kenya: protocol for a discrete choice experiment
title_fullStr Assessing preferences for HIV pre-exposure prophylaxis (PrEP) delivery services via online pharmacies in Kenya: protocol for a discrete choice experiment
title_full_unstemmed Assessing preferences for HIV pre-exposure prophylaxis (PrEP) delivery services via online pharmacies in Kenya: protocol for a discrete choice experiment
title_short Assessing preferences for HIV pre-exposure prophylaxis (PrEP) delivery services via online pharmacies in Kenya: protocol for a discrete choice experiment
title_sort assessing preferences for hiv pre exposure prophylaxis prep delivery services via online pharmacies in kenya protocol for a discrete choice experiment
url https://bmjopen.bmj.com/content/13/4/e069195.full
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