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

The study was conducted in four high HIV burden provinces in Vietnam, including Hanoi, Can Tho, Ho Chi Minh City, and Dong Nai, among a sample of 616 key populations, including 246 men who have sex with men (MSM), 124 transgender women (TGW), 121 female sex workers (FSW), and 125 people who inject drugs (PWID). The study found that 23.2% of key populations interviewed had heard of long-acting injectable PrEP, with 32.9% of MSM, 26.6% of TGW, 16% of PWID, and 7.4% of FSW having heard of it. Among those who had heard of long-acting injectable PrEP, 66.3% preferred it over oral PrEP, including 65.6% of MSM, 65.6% of FSW, 79.4% of PWID, and 63.4% of TGW. The top two reasons for selecting long-acting injectable PrEP were not having to remember to take pills regularly (66.8%) and greater convenience (50.9%). In contrast, the primary factors for choosing oral PrEP were not liking injections (42%) and greater convenience (35.5%). Key populations who preferred long-acting injectable PrEP had higher willingness to pay (WTP) for it than those who did not prefer it. Age was a significant factor in WTP for long-acting injectable PrEP, with younger key populations more willing to pay than older key populations. Just over a quarter of key populations interviewed indicated an unmet need for PrEP, ranging from 21.0% among PWID to 29.3% for MSM. The majority of key populations 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. Younger key populations were more interested in using long-acting injectable PrEP and more willing to pay for it. Just under half of respondents were willing to pay $60 per injection for long-acting injectable PrEP, which is near equivalent to the price of commercial oral PrEP in Vietnam. Nearly a fifth of key populations were not willing to pay for long-acting injectable PrEP. For long-acting injectable PrEP and other future long-acting PrEP products to be accessible, it will be important to align pricing with what key populations are willing to pay and offer subsidized products, applying a total market approach so all key populations can benefit from accessing the PrEP product of their choice at any given point in time. The study found that 80.1% of key populations were willing to pay $30 per injection for long-acting injectable PrEP, 66.7% were willing to pay $40, and 48.8% were willing to pay $60 per injection. 54.1% stated that long-acting injectable PrEP should cost $30 or less than oral PrEP, while 29.9% said it needed to be free. Transgender women and female sex workers were willing to pay a higher median price per injection than men who have sex with men and people who inject drugs.