Brief Report: Stated Preferences for Long-Acting Injectable ART Among Mobile Men Living With HIV in Malawi: A Qualitative Study.

IF 2.9 3区 医学 Q3 IMMUNOLOGY
Marguerite Thorp, Sam Phiri, Khumbo Phiri, Isabella Robson, Misheck Mphande, Kathryn Dovel, Risa Hoffman
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Abstract

Background: Long-acting injectable (LAI) antiretroviral medications are as effective as daily oral antiretroviral therapy (ART) and offer discreet, less frequent dosing. LAIs may be ideal treatment options for people who experience challenges with adherence to daily oral ART, including mobile men living with HIV (MLHIV).

Methods: We conducted a qualitative substudy within two parent trials in 24 health facilities in Malawi that enrolled MLHIV ≥15 years not on ART. We conducted in-depth interviews with a stratified random sample of participants who had taken oral ART and self-reported mobility (travel) during the 6-month study (≥1 trip of ≥3 nights). Interviews described cabotegravir/rilpivirine and asked about clients' stated preferences for LAI vs. oral ART and their reasoning. Interviews were translated, transcribed, coded in Atlas.ti, and analyzed using framework analysis.

Results: We interviewed 29 mobile MLHIV from July 1, 2022, to August 30, 2022, median age 36 years (interquartile range: 31-41), mean 28 nights away in the past 6 months (SD: 40). Nearly all participants (26/29) expressed a preference for LAI over daily oral ART because LAI would reduce the risks of forgetting to take pills and unwanted disclosure. Three men preferred oral ART primarily because of fear of side effects from a new medication. A few men reported they would change their preference if injection site reactions prevented them from working.

Conclusions: Mobile MLHIV in Malawi with previous ART adherence challenges expressed strong stated preferences for LAI over daily oral ART. Further research is needed to understand implementation challenges and potential effectiveness of LAI among harder-to-reach populations.

简要报告:马拉维携带艾滋病毒的流动男性对长效注射抗逆转录病毒药物的偏好:一项定性研究。
背景:长效注射(LAI)抗逆转录病毒药物与每日口服抗逆转录病毒治疗(ART)一样有效,并且剂量谨慎,频率较低。对于坚持每日口服抗逆转录病毒药物治疗有困难的人,包括携带艾滋病毒的流动男性,LAIs可能是理想的治疗选择。方法:我们在马拉维24家卫生机构的两项母试验中进行了定性亚研究,纳入了≥15年未接受抗逆转录病毒治疗的MLHIV。我们对分层随机抽样的参与者进行了深度访谈,这些参与者在6个月的研究期间(≥1次≥3晚的旅行)接受了口服抗逆转录病毒治疗并自我报告了活动(旅行)。访谈描述了卡波特韦/利匹韦林,并询问了客户对LAI和口服ART的偏好及其原因。采访被翻译、转录、编码在Atlas中。采用框架分析法进行分析。结果:从2022年7月1日至2022年8月30日,我们采访了29名流动MLHIV,中位年龄36岁(四分位数范围:31-41),过去6个月平均28晚(SD: 40)。几乎所有的参与者(26/29)都表示,与每日口服抗逆转录病毒治疗相比,LAI更受欢迎,因为LAI可以减少忘记服药和不必要的信息泄露的风险。三名男性更喜欢口服抗逆转录病毒治疗,主要是因为担心新药的副作用。一些男性报告说,如果注射部位的反应使他们无法工作,他们会改变自己的选择。结论:马拉维的流动MLHIV患者先前存在抗逆转录病毒治疗依从性方面的挑战,他们强烈表达了对LAI的偏好,而不是每日口服抗逆转录病毒治疗。需要进一步的研究来了解在难以接触到的人群中实施LAI的挑战和潜在有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.80
自引率
5.60%
发文量
490
审稿时长
3-6 weeks
期刊介绍: JAIDS: Journal of Acquired Immune Deficiency Syndromes​ seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide. JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.
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