Principal Investigator: Chelsea Morroni, MPH, MPhil, PhD, MBChB, DTM&H, DFSRH

Study Objectives:

Objective 1

• To conduct a comprehensive assessment of preferences for pre-exposure prophylaxis (PrEP) delivery among pregnant and breastfeeding women (PBFW) not living with HIV in Gaborone.

Specifically, we will:

• Conduct a discrete choice experiment (DCE) in n=150 among PrEP naive PBFW to understand preferences, attitudes and barriers/facilitators for long-acting HIV prevention, and co-provision of dual long-acting PrEP and contraception.
  • Prior to the DCE, we will conduct two focus group discussions with ~15 women from each site to inform the DCE data collection tool
  • The DCE will be followed by cognitive interviews (n=10 per site).

The study will compare results by PrEP using (South Africa) vs. PrEP naïve (Botswana) PBFW to understand any differences in preferences or attitudes.

Study Design:

A population-based discrete choice experiment (DCE) and detailed survey of attitudes and preferences to longer-acting PrEP modalities among pregnant and breastfeeding women. The DCE instrument will be informed by preliminary qualitative focus group discussions and cognitive interviews.

Study Population and Size:

The study will recruit 150 pregnant women and breastfeeding women who are PrEP-naïve from antenatal care in Gaborone.

• age ≥ 18 years, documented HIV-negative according to one fingerpick rapid tests (per national protocol for routine antenatal care)
• Pregnant or postpartum (up to 3 months),
• Able and willing to consent to study participation.

For objective 1, the DCE will be collected among n=150 PBFW in Gaborone. We will also describe and analyze statistical differences in preferences by pregnancy vs breastfeeding groups and PrEP using women vs. PrEP naïve women.

A sample size of at least 150 HIV-negative PBFW per site provides the study with sufficient power (>80%) to detect a 15-20% difference in preferences among PBFW by site. This sample size will also provide a balance of feasibility and timeliness of data collection.

Focus group discussions (FGDs)

• Up to 15 PBFW per site will be recruited for the FGDs for 2 FGDs

Cognitive Interviews

• Up to 10 PBFW per site will be recruited to participate in individual cognitive interviews

Discrete Choice Experiment

• All 150 PBFW will be administered the DCE instrument at a single timepoint

Study duration: 12 Months

Study Results: Study is on-going and no results yet.

Sponsor: Merck