Experiences with long acting injectable ART: A qualitative study among PLHIV participating in a Phase II study of cabotegravir + rilpivirine (LATTE-2) in the United States and Spain

Abstract

Challenges with adherence to daily oral antiretroviral therapy (ART) among people living with HIV (PLHIV) have stimulated development of injectable long-acting (LA) regimens. We conducted 39 in-depth interviews with participants and providers in a Phase IIb study (LATTE-2) evaluating an injectable LA regimen in the U.S. and Spain. Interviews exploring participant and provider attitudes and experiences with LA versus oral ART were audiotaped, transcribed and analyzed using thematic content analysis. Participants described the convenience of LA injections versus daily pills and emotional benefits such as minimized potential for HIV disclosure and eliminating the “daily reminder of living with HIV.” Providers recognized benefits but cautioned that LA candidates still need to adhere to clinic visits for injections and raised questions around ongoing clinical management. LA was seen as preferable to daily oral ART among PLHIV. Further research is needed regarding appropriate candidates, including with women and “non-adherent” populations across settings.

Interventions to Improve Antiretroviral Therapy Adherence Among Adolescents and Youth in Low- and Middle-Income Countries: A Systematic Review 2015–2019

“…We did not include studies which address such barriers through use of alternative regimens or formulations. Use of more potent and/or better tolerated ART regimens such as integrase inhibitors, long-acting and injectable regimens [75][76][77] have shown promise among adults and should be examined among adolescents and youth. Other medication-related interventions among adolescents and youth such as weekends off regimens have been shown to be non-inferior [78], and single-tablet regimens have achieved significantly higher VL suppression rates than multi-tablet regimens [79].…”

Terapia com antirretrovirais: grau de adesão e a percepção dos indivíduos com HIV/Aids

“…(27) In a study developed in East Africa, the presence of adverse effects negatively influence the antiretroviral therapy (28) and can affect different areas of human beings, ranging from the physical to the psychosocial. (29) Possible changes to improve compliance with HIV treatment identified in this study were supported by an international study, (30) in which individuals undergoing injectable antiretroviral therapy reported better compliance due to the monthly or six-monthly application regimen.…”

Patient-reported tolerability and acceptability of cabotegravir + rilpivirine long-acting injections for the treatment of HIV-1 infection: 96-week results from the randomized LATTE-2 study

“…14 In a separate substudy of participants (n ¼ 27) in the LATTE-2 study, qualitative interviews were conducted at sites in both the United States (n ¼ 11) and Spain (n ¼ 16) to explore participants' experiences with cabotegravir LA þ rilpivirine LA. 15 Findings underscored the convenience of LA injectable therapy versus daily oral pills and the emotional benefits such as ameliorating the experience of internalized stigma and the related "daily reminder of HIV." These logistical and psychosocial benefits helped participants live with more flexibility and with less anxiety over daily dosing and the risk of accidental HIV disclosure.…”