Preferences for pre-exposure prophylaxis among U.S. military men who have sex with men: results of an adaptive choice based conjoint analysis study

Mil Med Res. 2021 May 19;8(1):32. doi: 10.1186/s40779-021-00323-6.


Background: Pre-exposure prophylaxis (PrEP) prevents human immunodeficiency virus (HIV) infection, but its use remains low among U.S. military men who have sex with men (MSM), likely due to mis-matching with personal preferences. We conducted a study to characterize preferences to PrEP measures within this population.

Methods: HIV-negative military MSM were recruited through a closed, Lesbian, Gay, Bisexual, and Transgendered (LGBT) military social media group. The survey was anonymous, and consisted of five experimentally varied attributes in service delivery: 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.

Results: A total of 429 participants completed the survey. Among the eight scenarios with varying attributes, the most preferred scenario featured a daily tablet, PrEP injection or implant, along with a military provider, smartphone/telehealth visit, and on-base locations for lab evaluation and medication pick-up. The results also emphasized the importance for providers to be familiar with PrEP prescription knowledge, and to provide interactions sensitive to sexual identity and mental health.

Conclusion: A PrEP program consisting of daily tablet is preferred in military healthcare settings is preferred. Long-acting implants and injections are also desired.

Keywords: Conjoint analysis; Decision science; HIV; Infectious disease; Military health; Pre-exposure prophylaxis; Preference.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Bayes Theorem
  • Consumer Behavior / statistics & numerical data*
  • HIV Infections / drug therapy
  • HIV Infections / prevention & control*
  • Humans
  • Male
  • Military Personnel / psychology*
  • Military Personnel / statistics & numerical data
  • Pre-Exposure Prophylaxis / methods
  • Pre-Exposure Prophylaxis / standards*
  • Pre-Exposure Prophylaxis / statistics & numerical data
  • Sexual and Gender Minorities / psychology*
  • Sexual and Gender Minorities / statistics & numerical data
  • Surveys and Questionnaires
  • United States