A Conjoint Analysis of the Acceptability of Targeted Long-Acting Injectable Antiretroviral Therapy Among Persons Living with HIV in the U.S.

Simoni, Jane M.; Tapia, Kenneth; Lee, Sung–Jae; Graham, Susan M.; Beima‐Sofie, Kristin; Mohamed, Zahra H; Christodoulou, Joan; Ho, Rodney J. Y.; Collier, Ann C.

doi:10.1007/s10461-019-02701-7

Cited by 32 publications

(34 citation statements)

References 39 publications

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“…Certain subgroups seemed more receptive to LAI-ART, including young people and those experiencing adherence challenges. 11 The current study evolves from our program of work on acceptability of LAI-ART, 12,13 guided by a multi-level ecological framework that considers factors related to LAI-ART use at intra-and inter-personal, healthcare system, and broader structural and policy levels. As depicted in the Figure 1, product and delivery attributes and access as well as the individual factors of information, motivation, and behavioral (IMB) skills as postulated in the IMB framework 14 will likely be key influencers of acceptability and, ultimately, LAI-ART use.…”

Section: Introductionmentioning

confidence: 99%

“Lighten This Burden of Ours”: Acceptability and Preferences Regarding Injectable Antiretroviral Treatment Among Adults and Youth Living With HIV in Coastal Kenya

Simoni

Beima‐Sofie

Wanje

et al. 2021

J Int Assoc Provid AIDS Care

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Background: Long-acting injectable (LAI) antiretroviral therapy (ART) may offer persons living with HIV (PLWH) an attractive alternative to pill-based treatment options, yet acceptability data remain scant, especially in sub-Saharan Africa. Methods: We conducted 6 focus group discussions with PLWH, including key stake holder groups, and analyzed data with content analysis. Results: Initial reactions to the idea of LAI-ART were often positive. The primary advantages voiced were potential to facilitate improved adherence and alleviate the burden of daily pill-taking while avoiding inadvertent disclosure and HIV stigma. Potential side effects were a particular concern of the women. Most participants preferred clinic-based administration over self-injections at home due to concerns about safety, privacy, and potential need for refrigeration. Conclusions: LAI-ART may be acceptable in Kenya, provided injections are infrequent and delivered in a clinic setting. However, HIV stigma, fear of potential side effects, and limited clinical capacity would need to be addressed.

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Section: Introductionmentioning

confidence: 99%

“Lighten This Burden of Ours”: Acceptability and Preferences Regarding Injectable Antiretroviral Treatment Among Adults and Youth Living With HIV in Coastal Kenya

Simoni

Beima‐Sofie

Wanje

et al. 2021

J Int Assoc Provid AIDS Care

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“…Studies carried out among PLHIV receiving LA ART in the context of clinical trials have found that the majority of participants preferred LA over daily oral ART and reported significantly higher satisfaction with LA versus oral ART [8][9][10][11][12]. Research on the acceptability of LA ART among PLHIV conducted outside of trials where participants were receiving LA ART, also demonstrates significant interest in this potential treatment option [13][14][15]16].…”

Section: Introductionmentioning

confidence: 99%

“…In deciding whether to switch to LA or stay on oral ART, research has found that important factors considered by PLHIV include being reassured of the efficacy and side-effect profile of LA ART [11,13,14] and being able to manage potential injection site reactions (ISRs) [13,15]. Patient reported outcomes (PRO) data from clinical trials have found that experiences of pain and discomfort decreased over time as they became accustomed to the injections, and most ISRs were mild or moderate [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Patient reported outcomes (PRO) data from clinical trials have found that experiences of pain and discomfort decreased over time as they became accustomed to the injections, and most ISRs were mild or moderate [8][9][10]. Specific groups, including women living with HIV, have been found to express greater concern for ISRs [14,15]. A few studies found that some groups PLOS ONE (R01MH110158) and ViiV Healthcare.…”

Section: Introductionmentioning

confidence: 99%

“…It is unclear if and how LA ART perspectives may differ in the context of lower resource settings or among populations experiencing multiple structural constraints to HIV care [10]. Very few LA ART studies have been conducted among key populations with higher HIV prevalence, greater stigma and discrimination, and poorer treatment outcomes [13,14], and none of these included female sex workers (FSW). There is an urgent need to understand the perspectives of key populations living with HIV, such as FSW, who have lower ART adherence and viral suppression rates compared to women overall [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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“A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania

et al. 2020

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Background Long-acting injectable antiretroviral therapy (LA ART) was found to be non-inferior to daily oral ART in Phase 3 clinical trials. LA ART may offer an important alternative for people living with HIV with challenges adhering to daily oral ART or preferences for non-pill-based regimens. Methods Using a mixed methods approach integrating survey, in-depth interview and biological data from female sex workers (FSW) living with HIV in Tanzania (N = 208) and the Dominican Republic (DR) (N = 201), we assessed factors associated with the potential likelihood of LA ART use if it were available. We conducted multivariate logistic regression and thematic content analysis. Results Likelihood of LA ART use was high with 84.92% of FSW from the DR and 92.27% of FSW from Tanzania reporting they would be "likely" or "very likely" to use LA ART if available (p = 0.02). In Tanzania better HIV-related patient-provider communication (AOR 4.58; 95% CI 1.90-11.05) and quality of HIV clinical care (AOR 3.68; 95% CI 1.05-12.86) were positively

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U.S. patient preferences for long‐acting HIV treatment: a discrete choice experiment

et al. 2023

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Introduction Recent advances in long‐acting antiretroviral therapy (LA‐ART) could provide new options for HIV treatment and reduce adherence barriers, if regimens are acceptable to patients. We elicited preferences for key attributes of potential LA‐ART regimens among people with HIV (PWH) in the United States, focusing on four treatment modes (oral tablets, subcutaneous injections, intramuscular injections, and implants), product characteristics and location of administration. Methods A discrete choice experiment was conducted among PWH aged ≥18 years recruited from HIV clinics in Washington State and Atlanta, Georgia from March 2021 to June 2022. Participants responded to 17 choice scenarios, each with three options: two systematically generated hypothetical LA‐ART regimens and a constant opt‐out (their current daily oral treatment). LA‐ART regimen descriptions included treatment mode, pain, dosing frequency, location, pre‐treatment time with undetectable viral load, pre‐treatment negative reaction testing and “late‐dose leeway” (i.e. flexibility or forgiveness in timing the next dose). We used conditional logistic regression, with an interaction between treatment mode and pain, to estimate preference weights for all attribute levels. Results Seven hundred participants (350 at each site) enrolled, with median age 51 years (range 18–73); 70% identified as cisgender male, 24% as cisgender female and 6% as non‐binary or transgender. LA oral tablets were the only mode preferred over current daily oral treatment, with annual implants and injections the next most preferred LA‐ART option. Longer time between doses was preferred, and administration at home was preferred to clinics, which were preferred to pharmacies. Attributes with less impact on preferences included oral lead‐in treatment to achieve viral suppression or test for negative reactions and late‐dose leeway around the prescribed dosing interval. Participants in Atlanta were more likely to prefer their current daily oral ART than participants from Seattle. Conclusions PWH in the United States may soon have several options for LA‐ART. Our results suggest that LA oral tablets will be preferred by many patients over their current daily oral treatment, while implants and injections with longer duration may be acceptable to some. Future research should investigate sources of preference heterogeneity and actual uptake of and adherence to LA‐ART products, when available.

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A Conjoint Analysis of the Acceptability of Targeted Long-Acting Injectable Antiretroviral Therapy Among Persons Living with HIV in the U.S.

Cited by 32 publications

References 39 publications

“Lighten This Burden of Ours”: Acceptability and Preferences Regarding Injectable Antiretroviral Treatment Among Adults and Youth Living With HIV in Coastal Kenya

“Lighten This Burden of Ours”: Acceptability and Preferences Regarding Injectable Antiretroviral Treatment Among Adults and Youth Living With HIV in Coastal Kenya

“A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania

U.S. patient preferences for long‐acting HIV treatment: a discrete choice experiment

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