Background HIV pre-exposure prophylaxis (PrEP) is highly effective but not widely used by men who have sex with men (MSM; 27%) in China.Methods In June 2023, an online cross-sectional survey with a discrete choice experiment (DCE) was distributed to PrEP-eligible MSM in China who were at least 18 years old. The DCE explored attributes of PrEP modality (daily pill, on-demand pill, injections, implants), clinical care model (same-day, 2-visit, telehealth prescription), medication pickup (clinic, community health center, pharmacy, MSM-focused community-based organization, home delivery), enhanced support (self-management, smartphone app, text reminder, anonymous peer support group), and cost.Results A total of 1013 MSM completed the survey; the average age was 31 years, and a quarter had used PrEP. The most influential attributes were cost (relative importance: 64.6%), followed by PrEP modality (27.7%), medication pickup (4.0%), enhanced support (3.5%), and clinical care model (0.2%). The most preferred ways to access PrEP were no-cost on-demand pill, medication home delivery, self-management, and telehealth. The predicted uptake of on-demand PrEP was higher than other modalities, increasing from 22% with no subsidy to 79% with full subsidy, holding the other 3 attributes constant.Conclusions Chinese MSM have strong preferences regarding accessing PrEP: Low cost is a critical priority, especially important because medication and clinical care are currently entirely unsubsidized in China. Preferences for on-demand PrEP and home delivery indicate methods that the health care system can utilize to best meet the needs of MSM and factors that should be incorporated into future interventions.
[1]Emory Univ, Dept Behav Social & Hlth Educ Sci, Atlanta, GA USA.
[2]Duke Univ, Dept Polit Sci, Durham, NC USA.
[3]Danlan Publ Welf, Beijing, Peoples R China.
[4]Chinese Ctr Dis Control & Prevent, Natl Ctr AIDS STD Control & Prevent, Beijing, Peoples R China.
[5]Emory Univ, Dept Epidemiol, Atlanta, GA USA.
[6]Melbourne Sexual Hlth Ctr, Alfred Hlth, Melbourne, Australia.
[7]Monash Univ, Fac Med Nursing & Hlth Sci, Sch Translat Med, Melbourne, Australia.
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