Measuring PrEP Preferences Among At-Risk Military Populations: Results of an Adaptive Choice Based Conjoint Analysis Study

Abstract BACKGROUNDPre-exposure prophylaxis (PrEP) effectively prevents HIV infection, yet its uptake remains low among U.S. military men who have sex with men (MSM). Research shows that health services matching preferences produce favorable outcomes. Therefore, an early step for planning program design is to characterize and identify preferences for improved PrEP delivery within this population. METHODSHIV-negative military MSM were recruited through a closed, LGBT military social media group. Participants completed an anonymous survey presenting five experimentally varied attributes of interest related to PrEP administration (dosing method, provider type, visit location, lab work evaluation location, and dispensing venue). Relative importance and part-worth utility scores were generated using Hierarchical Bayes (HB) estimation, and the randomized first choice model was used to examine participation interest across eight possible PrEP program scenarios. RESULTSAmong the 429 participants and the eight scenarios that varied the five attributes into delivery profiles, the most preferred scenario (69.9%) featured a daily pill or long-term PrEP injection, military provider, smartphone/telehealth visit, lab evaluation on-base, and on-base medication pick-up. Responses indicated the need for providers to familiarize themselves with PrEP prescription knowledge and to provide interactions sensitive to sexual identity, mental health, and decision autonomy. CONCLUSIONThese results suggest that a military setting is preferred over a civilian or off-site one, yet more importantly, it points to a high value placed on the quality of clinical interactions. High interest in long-acting implants and injections also suggest potential markets for future PrEP engagement.