Couples' Preferences for "2 in 1" Multipurpose Prevention Technologies to Prevent Both HIV and Pregnancy: Results of a Discrete Choice Experiment in Uganda and Zimbabwe

Alexandra M Minnis, Juliane Etima, Petina Musara, Erica N Browne, Prisca Mutero, Doreen Kemigisha, Nyaradzo M Mgodi, Clemensia Nakabiito, Mary Kate Shapley-Quinn, Marie C D Stoner, Miriam Hartmann, Nicole Macagna, Jeanna Piper, Ariane van der Straten, Alexandra M Minnis, Juliane Etima, Petina Musara, Erica N Browne, Prisca Mutero, Doreen Kemigisha, Nyaradzo M Mgodi, Clemensia Nakabiito, Mary Kate Shapley-Quinn, Marie C D Stoner, Miriam Hartmann, Nicole Macagna, Jeanna Piper, Ariane van der Straten

Abstract

End-user input early in biomedical product development may optimize design to support high uptake and adherence. We interviewed 400 couples (800 total participants) in Uganda and Zimbabwe to assess their preferences for multipurpose prevention technologies (MPTs) for HIV and pregnancy prevention. Using a discrete choice experiment, couples made a series of choices between hypothetical MPTs, including oral tablets and vaginal rings, inserts, and films and completed an interviewer-administered questionnaire assessing sociodemographic and behavioral measures. Most couples preferred presented MPTs over male condoms. Couples' MPT choices in both countries were influenced most by the combination of product form and dosing frequency, with monthly dosing preferred over daily. Analysis highlighted differences by country as to which side effects were most important: Ugandan couples placed greater importance on effects on the vaginal environment during sex, whereas Zimbabwean couples placed more importance on changes to menstruation and other side effects (headache, cramps). Couples' preferences signaled an openness to new product forms and more frequent dosing if preferred characteristics of other attributes were achieved.

Keywords: Acceptability; Contraception; Couples; Discrete choice experiment; HIV prevention; Multipurpose prevention technology (MPT).

Conflict of interest statement

The authors have no conflict of interest or financial interests relevant to this article to disclose.

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Figures

Fig. 1
Fig. 1
Attributes with corresponding levels included in the discrete choice experiment for a dual-purpose (pregnancy and HIV) prevention product
Fig. 2
Fig. 2
Estimated normalized preference weights with 95% confidence intervals from random parameter logit models, one for each geographic location

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