Measuring PrEP Preferences Among U.S. Military Men Who Have Sex with Men: Results of an Adaptive Choice Based Conjoint Analysis Study

Abstract Background Pre-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. Methods HIV-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.Results Among the 429 participants and the eight scenarios that varied the five attributes into delivery profiles, the most preferred scenarios featured a daily tablet, PrEP injection, or PrEP implant, along with a military provider, smartphone/telehealth visit, and on-base locations for lab evaluation and medication pick-up. Responses emphasized the importance for providers to be familiar with PrEP prescription knowledge, and to provide interactions sensitive to sexual identity and mental health.Conclusion These results suggest that a daily tablet PrEP program within a military healthcare 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.