The systematic development of attributes and levels for a discrete choice experiment of HIV patient preferences for long-acting antiretroviral therapies in the United States

• Type of Material: Article
• Authors: Aaron T Brah, University of Washington; Douglas Barthold, University of Washington; Brett Hauber, University of Washington; Ann C Collier, University of Washington; Rodney JY Ho, University of Washington; Vincent Marconi, Emory University; Jane M Simoni, University of Washington; Susane M Graham, University of Washington
• Language: English
• Date: 2022-02-25
• Publisher: BMC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12981-022-00435-6
• Title of Journal or Parent Work: AIDS RESEARCH AND THERAPY
• Volume: 19
• Issue: 1
• Start Page: 13
• End Page: 13
• Grant/Funding Information: This work was supported by NIH Grant R01 MH121424, UM1AI120176 and by the University of Washington/Fred Hutch Center for AIDS Research, an NIH-funded program under award number AI027757 which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, NIDDK. VCM received support from the Emory CFAR [P30AI050409].
• Keywords: PREVENTION; ADULTS; Infectious Diseases; Life Sciences & Biomedicine; Science & Technology
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Introduction: Patient preferences for long-acting antiretroviral therapies (LA-ART) should inform development of regimens with optimal adherence and acceptability. We describe a systematic process used to identify attributes and levels for a discrete choice experiment (DCE) designed to elicit preferences for potential LA-ART options in the US. Methods: Our approach was conducted in four stages: data collection, data reduction, removing inappropriate attributes, and optimizing wording. We started with 8 attributes defining potential LA-ART products based on existing literature and knowledge of products in development. We conducted 12 key informant interviews with experts in HIV treatment. The list of attributes, the set of plausible levels for each attribute, and restrictions on combinations of attribute levels were updated iteratively. Results: Despite uncertainty about which products will become available, key informant discussions converged on 4 delivery modes (infusions and patches were not considered immediately feasible) and 6 additional attributes. Treatment effectiveness and frequency of clinical monitoring were dropped. Oral lead-in therapy was split into two attributes: pre-treatment time undetectable and pre-treatment negative reaction testing. We omitted product-specific systemic and local side effects. In addition to mode, the final set of attributes included: frequency of dosing; location of treatment; pain; pre-treatment time undetectable; pre-treatment negative reaction testing; and late-dose leeway. Conclusions: A systematic process successfully captured elements that are both feasible and relevant to evaluating the acceptability of potential LA-ART alternatives to patients.