TY - JOUR
T1 - Preferences for PrEP program attributes among Black women aged ⩾45 in the US South
T2 - A secondary analysis using discrete choice experiment
AU - Sophus, Amber I.
AU - Mitchell, Jason W.
AU - Mangum, Laurenia
AU - Fuentes, Joanna Fernandez
AU - Collins, Shawndasia
AU - Gamble-George, Joyonna
AU - Hill, Mandy J.
AU - Stockman, Jamila K.
AU - Dubov, Alex
N1 - Publisher Copyright:
© The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
PY - 2026/1/1
Y1 - 2026/1/1
N2 - Background: Among Black women (BW), HIV prevalence is higher among women aged ⩾45 than among those aged <30 years. Pre-exposure prophylaxis (PrEP), a highly effective biomedical HIV prevention method, could be effective at reducing HIV incidence among this population. Objectives: To identify PrEP program features most important to aging BW and to examine how these preferences can inform program design using discrete choice experiment. Design: We employed secondary data analysis using a choice-based conjoint analysis (CBC), a discrete choice experiment technique. Methods: Between June and August 2024, 390 cisgender BW were recruited online, screened for eligibility, provided e-consent, and completed a one-time CBC survey of 14 choice tasks across 6 PrEP program attributes: (1) administration method, (2) access location, (3) healthcare integration, (4) provider demographics, (5) payment options, and (6) support services. We examined PrEP program preferences only among those aged ⩾45 (N = 83 of N = 390). Hierarchical Bayes model estimated attribute importance; latent class multinomial logit analysis grouped participants by similar preferences. Results: PrEP administration method was the top-ranked attribute (39%), followed by provider demographics (14%) and payment options (13%). Preferences were clustered into three distinct groups. Group 1 (n = 8) showed higher proportions of worry about acquiring HIV and preferred only a daily pill by a doctor’s office. Group 2 (n = 35) faced descriptively higher HIV vulnerability and favored injectable PrEP via telehealth supported (in-person) injection delivery from a female provider. Group 3 (n = 40) had the strongest interest and intention to use PrEP, preferring injectable PrEP from a pharmacist of the same race. Compared to the full sample, aging BW valued PrEP administration, prioritized gender matching alone, and payment options. Conclusion: PrEP program preferences are not uniform among aging BW. Rather than relying on a single PrEP delivery model, programs should be tailored to specific preferences for aging women who consider multiple factors and may need personalized support in PrEP decision-making.
AB - Background: Among Black women (BW), HIV prevalence is higher among women aged ⩾45 than among those aged <30 years. Pre-exposure prophylaxis (PrEP), a highly effective biomedical HIV prevention method, could be effective at reducing HIV incidence among this population. Objectives: To identify PrEP program features most important to aging BW and to examine how these preferences can inform program design using discrete choice experiment. Design: We employed secondary data analysis using a choice-based conjoint analysis (CBC), a discrete choice experiment technique. Methods: Between June and August 2024, 390 cisgender BW were recruited online, screened for eligibility, provided e-consent, and completed a one-time CBC survey of 14 choice tasks across 6 PrEP program attributes: (1) administration method, (2) access location, (3) healthcare integration, (4) provider demographics, (5) payment options, and (6) support services. We examined PrEP program preferences only among those aged ⩾45 (N = 83 of N = 390). Hierarchical Bayes model estimated attribute importance; latent class multinomial logit analysis grouped participants by similar preferences. Results: PrEP administration method was the top-ranked attribute (39%), followed by provider demographics (14%) and payment options (13%). Preferences were clustered into three distinct groups. Group 1 (n = 8) showed higher proportions of worry about acquiring HIV and preferred only a daily pill by a doctor’s office. Group 2 (n = 35) faced descriptively higher HIV vulnerability and favored injectable PrEP via telehealth supported (in-person) injection delivery from a female provider. Group 3 (n = 40) had the strongest interest and intention to use PrEP, preferring injectable PrEP from a pharmacist of the same race. Compared to the full sample, aging BW valued PrEP administration, prioritized gender matching alone, and payment options. Conclusion: PrEP program preferences are not uniform among aging BW. Rather than relying on a single PrEP delivery model, programs should be tailored to specific preferences for aging women who consider multiple factors and may need personalized support in PrEP decision-making.
KW - PrEP
KW - aging
KW - choice-based conjoint analysis
KW - discrete choice experiment
KW - pre-exposure prophylaxis
UR - https://www.scopus.com/pages/publications/105036799117
UR - https://www.scopus.com/pages/publications/105036799117#tab=citedBy
U2 - 10.1177/17455057261437288
DO - 10.1177/17455057261437288
M3 - Article
C2 - 42028822
AN - SCOPUS:105036799117
SN - 1745-5057
VL - 22
JO - Women's Health
JF - Women's Health
ER -