Patient and Physician Preferences Regarding Long-Acting Pre-Exposure Prophylaxis and Antiretroviral Therapy: A Mixed-Methods Study in Southern California, USA.

eScholarship, University of California 2022-11-01

Antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) are key strategies in ending the HIV epidemic. However, poor adherence to daily ART and PrEP increases the risk of HIV transmission and acquisition. Long-acting ART and PrEP formulations attempt to improve adherence through providing long-lasting forms of the medication delivered through different routes of administration: oral (potentially monthly), injection (1-6 months), and subdermal implant (up to annually). This study explored patient and physician preferences for long-acting ART and PrEP as well as adherence support strategies. Adult patients (n = 42) with experience taking ART or PrEP participated in individual interviews or focus groups. Physicians (n = 13) currently prescribing ART and/or PrEP completed an online questionnaire. Rapid qualitative analysis systematically synthesized qualitative data, and descriptive statistics examined survey responses. Patients supported improved adherence as a top potential advantage of long-acting ART and PrEP, and reduced internal stigma as a strong benefit specific to long-acting ART. Annual coverage offered through subdermal implants had strong appeal; however, oral was the preferred modality for long-acting ART and PrEP. Patients preferred injectable ART and PrEP if concurrently receiving hormone therapy injections. Side effects, medication cost, and treatment accessibility were potential barriers. Patients preferred calendar tracking and text messages/phone reminders for adherence supports. Physicians reported that they would reduce clinic visits and HIV testing for all patients on long-acting PrEP, except men who have sex with men who would continue to complete HIV testing every 3 months. Physicians were mixed on whether they believed long-acting ART and PrEP would improve patient adherence. Overall, findings demonstrate the potential benefits of long-acting ART and PrEP, while highlighting the need to obtain additional information to address treatment

Humans; HIV Infections; Anti-HIV Agents; Homosexuality; Male; Adult; Physicians; Pre-Exposure Prophylaxis; Sexual and Gender Minorities; HIV; antiretroviral therapy; long-acting antiretrovirals; medication adherence; pre-exposure prophylaxis; qualitative; Behavioral and Social Science; Sexual and Gender Minorities (SGM/LGBT*); Pediatric AIDS; Prevention; Pediatric; Clinical Trials and Supportive Activities; Infectious Diseases; Mental Health; Clinical Research; HIV/AIDS; Evaluation of treatments and therapeutic interventions; Management of diseases and conditions; 6.1 Pharmaceuticals; 7.1 Individual care needs; Infection; Good Health and Well Being; Clinical Sciences; Virology; article

Open access content. Open access content
CC-BY-NC

AIDS research and human retroviruses vol 38, iss 11, 856-862 0889-2229

CDLER oai:escholarship.org:ark:/13030/qt2gr7s2bz
qt2gr7s2bz
https://escholarship.org/uc/item/2gr7s2bz
https://escholarship.org/
1367387617

UC MASS DIGITIZATION
From OAIster®, provided by the OCLC Cooperative.

edsoai.on1367387617