Study suggests side-effects and costs are biggest concerns for users of HIV pre-exposure prophylaxis johnshopkinssph
], consistent with our results; this study expands on that work and shows the importance of these attributes across all modalities of PrEP. A DCE of PrEP preferences in the US military found mode of administration to be the most important attribute in both those with and without experience taking PrEP, but neither cost nor side-effects were included in that DCE [].
PrEP preferences also varied by demographic group and with different levels of PrEP experience. Lower-income respondents were more sensitive to out-of-pocket PrEP costs. Additionally, those with experience taking PrEP were more sensitive to these costs, suggesting that past experience with PrEP was negatively impacted by the actual out-of-pocket costs of PrEP they experienced.
In our study, small increases in cost were not associated with large decreases in interest in PrEP. The tradeoffs we simulated between cost and side-effects also suggests that low PrEP costs alone may not be enough to encourage uptake. Simulated PrEP uptake was more impacted by even short-term side effects upon starting than costs of PrEP of at least $25.
Keeping out-of-pocket costs low or none is of critical importance to maximize uptake. The US has several models for PrEP assistance that can make total out-pocket costs close to $0.
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