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

Abstract

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.

Enfrentamento da condição de saúde na perspectiva de pessoas com HIV que abandonaram o tratamento

“…É inquestionável que a adesão à TARV constitui fator fundamental na supressão total da replicação viral e na promoção da qualidade de vida, porém ainda existem obstáculos relacionados aos efeitos colaterais. Nesse sentido, no intuito de minimizar esses impactos, pesquisa realizada na costa do Quênia, com 49 adultos e jovens que vivem com HIV, apontou que modelos de tratamentos inovadores, como a TARV injetável, possibilitam a redução dos efeitos colaterais e, consequentemente, do abandono de tratamento (30) .…”

Self-injected contraceptives: does the investment reflect women’s preferences?

“…Similar hesitancies towards self-injection and preference for administration by a trained health provider have been noted with self-care injectable methods for long-acting antiretroviral therapy. 36 …”

“…self-care injectable methods for long-acting antiretroviral therapy. 36 Given the current knowledge base, it remains unclear whether increased training on self-injection will increase comfort and ease women's qualms. In some cases, such as in Nigeria where two training sessions are required before a woman can take home DMPA-SC for selfinjection, long learning periods may pose as a burden.…”

Coping with the health condition from the perspective of people with HIV who abandoned treatment

“…It is unquestionable that compliance with ART is a fundamental factor in the total suppression of viral replication and in quality of life promotion, but there are still obstacles related to side effects. In this sense, In order to minimize these impacts, research carried out on the coast of Kenya, with 49 adults and young people living with HIV, pointed out that innovative treatment models, such as injectable ART, make it possible to reduce side effects and, consequently, treatment abandonment (30) .…”