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Acceptability of and willingness to pay for long-acting injectable pre-exposure prophylaxis among men who have sex with men, transgender women, female sex workers and people who inject drugs in Vietnam

Title
Acceptability of and willingness to pay for long-acting injectable pre-exposure prophylaxis among men who have sex with men, transgender women, female sex workers and people who inject drugs in Vietnam
Presenter
Kimberly Elizabeth Green
Authors
K.E. Green * (1), H. Phan Thi Thu (2), B. Ngoc Vu (1), N. Nguyen (3), T. Minh Le (4), Y. Nguyen Vu (1)
Institutions
(1) PATH, Hanoi, Vietnam, (2) Vietnam Administration for AIDS Control, Hanoi, Vietnam, (3) Institute of Medical and Social Studies, Hanoi, Vietnam, (4) Glink Social Enterprise, Ho Chi Minh City, Vietnam

BACKGROUND: Oral pre-exposure prophylaxis (PrEP) was first introduced in 2017 and has since been made available in nearly half of the provinces in Vietnam. The Ministry of Health was fast to adopt national PrEP guidelines (2017) and event-driven (ED) PrEP (2020), and has approved a five-year plan to reach 70,000 people by 2025 with a range of models and formulary including long-acting injectable PrEP.
METHODS: To assess acceptability of and willingness to pay (WTP) for long-acting injectable PrEP (cabotegravir (CAB-LA), specifically), we implemented a cross-sectional study in four high-burden HIV provinces among 246 men who have sex with men (MSM), 124 transgender women (TGW), 121 female sex workers (FSW) and 125 people who inject drugs (PWID) as part of a larger study on use, preferences and WTP of health services. Snowball sampling was applied among KP seeking services from KP-led clinics and community-based organizations. Interviews were conducted in person or online based on participant preference.
RESULTS: In all, 23.2% of KP interviewed had heard of CAB-LA: 32.9% of MSM, 26.6% of TGW, 16% of PWID and 7.4 of FSW. Among the 65.3% (n=402) KP taking or interested in taking PrEP, 62.2% said they preferred long-acting injectable PrEP over oral PrEP (daily or ED) including 63.8% of MSM, 63.6% of FSW, 61.6% of PWID and 58.1% of TGW. The top two reasons for selecting long-acting injectable PrEP were not having to remember to take pills regularly (61.4%), and greater convenience (48.6%). While for those choosing oral PrEP, not liking injections (37.8%) and greater convenience (34.8%) were the primary factors. Overall 80.1% of KP were WTP $30, 66.7% $40 and 48.8% $60 per CAB-LA' injection; 54.% stated CAB-LA should cost = or < than oral PrEP while 29.9% said it needed to be free.
CONCLUSIONS: Awareness of CAB-LA was modest overall though higher among MSM and TGW. Of those using/interested in using PrEP, nearly two-thirds indicated a desire to use long-acting injectable PrEP over oral PrEP while both groups highlighted convenience as an important factor in their decision making. Ensuring CAB-LA is offered at low-cost or free of cost will be crucial for uptake.