Community HIV clinicians’ perceptions about HIV cure-related research in the Northwestern United States

Figures & data

Table 1. Demographic characteristics of HIV clinicians (Seattle, WA, United States, 2021).

Demographics	n	%
Gender
Male	5	42%
Female	7	58%
Ethnicity/Race
Caucasian/White	10	83%
Black/African American	0	0%
Latinx	0	0%
American Indian, Alaska Native, Native Hawaiian, Other Pacific Islander	0	0%
Asian descent	2	17%
Type of provider
Infectious diseases specialist (MD)	5	42%
Family practice/general medicine (MD)	2	17%
Advanced registered nurse practitioner	2	17%
Physician assistant/PharmD	1	8%
Internal medicine (MD)	1	8%
Hematology/oncology/HIV (MD)	1	8%
Health care setting
Hospital-based clinic	3	25%
Private practice	3	25%
Community health center (CHC)/Ryan White clinic	1	8%
Federally qualified health center (FQHC)/Ryan White Clinic	1	8%
Mixed settings	4	33%
Time providing HIV care
3 − 5 years (#s 107, 110)	2	16%
>5 − 10 years (#s 105,112, 114)	3	25%
>10 − 25 years (#s 101, 102, 113, 115)	4	33%
More than 25 years (#s 104, 106, 108)	3	25%
Number of patients
11 − 25 patients (#104)	1	8%
26 − 50 patients (#s 105, 107, 110, 113)	4	33%
50 − 99 patients	0	0%
>100 patients (#s 101, 102, 108, 112, 114, 115)	7	58%

Notes:

Clinicians 103, 109 and 111 withdrew from the study due to time constraints.

One provider gives gender-affirming care.

Table 2. Clinician suggestions for keeping HIV providers informed about HIV cure research.

Trial referrals	Easily navigable, searchable website or app with information on open HIV cure trials, entry criteria, study aims, etc.
	Trial brochures/postcards to give patients
	Laminated sheet summarizing open trials
	Brief talks at provider meetings providing study overviews
	Phone numbers of a designated staff member to answer questions if patient/provider wants to learn more about a specific trial
Advances in HIV cure research	General review of cure research developments in major conference update presentations (Conferences on Retroviruses and Opportunistic Infections/International AIDS Society/Infectious Diseases Society of America)*
	Review updates at national conferences*
	HIV cure research updates at community-oriented conferences, e.g., Ryan White*
	Local/regional seminars (preferably with Continuing Medical Education (CME) credits)*
	Online seminars that can be accessed any time*
	Single day pre-conferences at national or international conferences*
	Email/listservs (although recommended, several noted that they are inundated with too many emails)
	Monthly email update customized for clinicians
	Publications in clinician-oriented journals
	Podcasts/Twitter feeds (free of pharma influence)

* Use language that can be understood by non-scientists.

Table 3. Suggestions for bridging the divide between community clinicians and trial investigators engaged in HIV cure research.

Suggestions for trial investigators	Suggestions for community clinicians
Set up an easily searchable online repository of local open HIV cure trials, including inclusion/exclusion criteria	Learn about HIV cure-related trials open to enrollment at ClinTrials.Gov (https://clinicaltrials.gov/) and the Treatment Action Group HIV cure trial listing (https://www.treatmentactiongroup.org/cure/trials/)
Devise simple trial referral mechanisms that include contact information (a phone number or email address) and a live person from the study team to interact with	Become familiar with local trials, their aims, and requirements, prior to advising patients on participation
Create study recruitment materials that follow plain language and people-first principles that include a phone number for talking with a study team member that clinicians can give to their patients; refer to the NIAID HIV Language Guide https://daidslearningportal.niaid.nih.gov/local/pages/?id=17	Take advantage of opportunities to learn about HIV cure research progress via mechanisms designed to be accessible to non-scientists, such as the ‘Young Investigators’ Symposium’ at CROI, or post conference community summary presentations
Inform local providers about current or upcoming studies, via calls, staff meeting presentations, webinars, or community-wide in-person presentations; begin education and building relationships prior to study launch	Invite local HIV cure trial investigators to present their study at a team meeting if there are locally available open trials
Develop a written plan for how/when study labs and other information of clinical importance will be shared with clinicians whose patients are enrolled; share this with clinicians when introducing the study	Share any concerns about a specific local trial with the investigators, and any recommendations that would make the trial more palatable to refer patients
Generate a Frequently Asked Questions (FAQs) document, simplified protocol, or other summary document detailing study goals, expectations of participants, labs, safety monitoring plan, clinician communication plan, and how participants will be encouraged to remain engaged with their clinical care; include ATI rationale, monitoring plan, ART restart plans, partner safety plan, if trial includes ATI	Share study recruitment/explanatory materials with patients who express interest in HIV cure research
Eliminate burdens on referring clinicians as much as possible; invite their ongoing feedback to identify these challenges to the referral process	Subscribe to an HIV cure listserv or digest
Design participant education materials that emphasize the importance of staying engaged with their clinical care teams while in the study. If there is an ATI or treatment delay involved, education materials should also include information on why the ATI or delay is needed, how their safety is being protected, and the importance of taking their medications correctly post ATI or ART initiation delay.

Data availability

All data relevant to this study have been provided in the text and in the Supplementary Appendices.