Use of conjoint analysis to assess HIV vaccine acceptability in three populations:

1. Use of conjoint analysis to assess HIV vaccine acceptability in three populations: An innovation in the assessment of consumer healthcare preferences (Project VIBE) Sung-Jae Lee, Ph.D., Peter A. Newman, Ph.D., William E. Cunningham, MD, M.P.H., Danielle Seiden, M.P.P., Naihua Duan, Ph.D.

2. Outline • Background • Assessing HIV Vaccine Acceptability • Methodology • Conjoint Analysis • Results • Three Samples • Conclusions • Application in HIV Vaccine Acceptability

3. BACKGROUND

4. What will happen when HIV vaccines become publicly available?

5. “If we build it, they will come!” …but will they???

6. Sub-optimal Uptake of Existing Vaccines • Non-institutionalized U.S. adults 18 – 64 yrs • 23% – 47% influenza vaccine • 20% – 58% pneumococcal vaccine • Lower coverage rates – African Americans, Latinos, low SES

7. HIV vaccine uptake is not guaranteed

8. Conjoint Analysis • Well established research technique to predict consumer preferences when faced with a number of products varying across specific attributes (Green, 1999) • Extensive use in psychology, marketing, and economics

9. Conjoint Analysis • Growing application in measuring health care preferences (Phillips 2002, 2006), ranging from microbicide use (Holt, 2006) and anti-inflammatory drugs (Fraenkel, 2004) to hearing aids (Meister, 2002) and glaucoma treatment (Bhargava, 2006)

10. Objective • Conjoint Analysis • To test the feasibility of conjoint analysis application to measure HIV vaccine acceptability among three diverse communities in Los Angeles, California and Toronto, Canada.

11. METHODS

12. Participants • Multi-ethnic communities in Los Angeles, California • At risk communities; Individual interviews; n=143 • Thai Residents in Los Angeles, California • Three focus groups; n=27 • Aboriginal Canadians, Toronto, Canada • Two focus groups; n=13

13. Conjoint Analysis Methods • Assigning levels of attributes: • Integrating input from focus group results, HIV vaccine experts, published and unpublished literature • Hypothetical HIV vaccine being composed of a bundle of 7 dichotomous attributes

14. HIV Vaccine Attributes

15. Conjoint Analysis Methods • Assigning conjoint scenarios: • (27= 128) hypothetical scenarios • Fractional factorial design • 8 hypothetical HIV vaccines • Conjoint analysis in different modalities

16. Rating Hypothetical HIV Vaccines Rate eight hypothetical HIV vaccines from “Highly likely” to “Highly unlikely”

17. Conjoint Scenario Cards

18. Conjoint Analysis Methods • Estimate acceptability score for each vaccine by averaging individual vaccine ratings across participants • One sample t-test to determine impact significance

19. RESULTS

20. HIV Vaccine Acceptability

21. HIV Vaccine Acceptability

22. Impact of Vaccine Attributes on HIV Vaccine Acceptability

23. CONCLUSIONS

24. Conclusions • Conjoint analysis provided insight into HIV vaccine acceptability among diverse potential consumers • Vaccine acceptability varied widely across 8 vaccines with different attributes • Efficacy had the greatest impact on acceptability • Attribute impacts varied across three samples

25. Conclusions • We demonstrated successful applications of conjoint analysis • Individual setting ( with a skilled interviewer) • Group setting (with trained facilitators)

26. Marketing & Economics Biomedical Science Conjoint Analysis Behavioral Science HIV Vaccine Acceptability

27. L.A. VOICES VOICES VOICES New Initiatives • L.A. VOICES: Post-trial HIV Vaccines: Receptivity, Risk & Disparities (R01-MH-069087-01A1) • Sisters, Mothers, Daughters & Aunties: Protecting Black Women against HIV (Canadian Institutes of Health Research) • HIV Vaccine Acceptability in Thailand (Social Sciences & Humanities Research Council, Canada) • HIV Vaccine Trial Participation & Community Engagement (Ontario HIV Treatment Network)

28. References • Duan N. Listening to consumers and HIV vaccine preparedness. Lancet. 2005 Apr;365(9465):1119-21. [See also The Lancet: The trials of tenofovir trials. Lancet. 2005 April;365(9465):1111.)] • Newman P.A., Duan, N., Lee, S-J., Rudy, E.T., Seiden, D.S., Kakinami, L., Cunningham, W.E. HIV vaccine acceptability among communities at risk: The impact of vaccine characteristics. Vaccine. 2006 Mar 15;24(12):2094-101.

29. Supported By • UCLA AIDS Institute Seed Grant (CC99-LA-002) • UCLA AIDS Institute and Palotta Teamworks AIDS Vaccine Rides • Center for HIV Identification Prevention and Treatment Services (P30 MH 58107) • Social Sciences and Humanities Research Council Institutional Grant (Canada)

30. Acknowledgements • Thanks to Peter Anton, Lauren Arguelles, Phil Batterham, Ned Bayrd, Omar Banos, Ron Brooks, Coleen Cantwell, Suzi Cantwell, Mark Etzel, Kathie Ferbas, Neil Gajasan, Sonia Johnson, Ella Kelly, Faith Landsman, Kathy Mattes, Irma Ocegueda, Rowell Ramos, Fen Rhodes, Mary Jane Rotheram, Rassamee Sangthong, Dallas Swendeman, Julian Wang, Michael Woodford, Shin-Yi Wu, Paul Xue • Special thanks to all participants, study sites & key informants without whom this research would not have been possible.

31. For more information, please contact: Sung-Jae Lee, Ph.D. Semel Institute Neuroscience and Human Behavior, UCLA Center for Community Health sjlee@mednet.ucla.edu Peter Newman, Ph.D.University of Toronto Faculty of Social Work 246 Bloor Street West Toronto, Ontario M5S 1A1 CANADA p.newman@utoronto.ca Naihua Duan, Ph.D. Semel Institute Neuroscience and Human Behavior, UCLA Health Service Research Center naihua@mednet.ucla.edu