Who wants long-Acting injectable antiretroviral therapy? Treatment preferences among adults with HIV in Florida

ABSTRACT

Long-acting injectable (LAI) antiretroviral therapy (ART) is available to people with HIV (PWH), but it is unknown which PWH prefer this option. Using the Andersen Behavioral Model this study identifies characteristics of PWH with greater preference for LAI ART. Cross-sectional data from the Florida Cohort, which enrolled adult PWH from community-based clinics included information on predisposing (demographics), enabling (transportation, income), and need (ART adherence <90%) factors. ART preference was assessed via a single question (prefer pills, quarterly LAI, or no preference). Confounder-adjusted multinomial logistic regressions compared those who preferred pills to the other preference options, with covariates identified using directed acyclic graphs. Overall, 314 participants responded (40% non-Hispanic Black, 62% assigned male, 63% aged 50+). Most (63%) preferred the hypothetical LAI, 23% preferred pills, and 14% had no preference. PWH with access to a car (aRRR 1.97 95%CI 1.05–3.71), higher income (aRRR 2.55 95%CI 1.04–6.25), and suboptimal ART adherence (aRRR 7.41 95% CI 1.52–36.23) were more likely to prefer the LAI, while those who reported having no social network were less likely to prefer the LAI (aRRR 0.32 95% CI 0.11–0.88). Overall LAI interest was high, with greater preference associated with enabling and need factors.

KEYWORDS:

• HIV
• long-acting antiretroviral therapy
• antiretroviral therapy
• end-user preferences

Sustainable Development Goals:

• SDG 3: Good health and well-being

Acknowledgements

This work was supported by the National Institute on Alcohol Abuse and Alcoholism under awards F31AA030518 (RFH) and U24AA022002 (RLC). Additionally, this work is supported in part by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme LLC (YL and MP). The opinions expressed in this paper are those of the authors and do not necessarily represent those of the National Institute on Alcohol Abuse and Alcoholism or Merck Sharp & Dohme LLC. Data are available from the Southern HIV and Alcohol Research Consortium upon request through the concept system.

Authorship contributions

Conceptualization: Fisk-Hoffman, Liu, Cook; Methodology: Fisk-Hoffman, Prosperi, Cook; Formal Analysis: Fisk-Hoffman; Writing- Original Draft: Fisk-Hoffman; Writing- Review & Editing: Liu, Widmeyer, Somboonwit, Prosperi, Cook; Visualization: Fisk-Hoffman; Supervision: Prosperi, Cook; Funding Acquisition: Fisk-Hoffman, Liu, Prosperi.

Data availability

Florida Cohort data can be requested through the Southern HIV and Alcohol Research Consortium Concept System (https://sharc-research.org/research/data/sharc-concepts-system/).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Institute on Alcohol Abuse and Alcoholism under awards F31AA030518 (RFH) and U24AA022002 (RLC). Additionally, this work is supported in part by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme LLC (YL and MP).