Identifying preferred program delivery attributes for long-acting injectable cabotegravir-rilpvirine in three U.S. HIV clinics: A discrete choice experiment.

IF 2.2 3区医学 Q3 IMMUNOLOGY

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-03-13 DOI:10.1097/QAI.0000000000003661

Jose I Gutierrez, Elizabeth T Montgomery, Samantha E Dilworth, Moira C McNulty, Jonathan A Colasanti, Mallory O Johnson, Kimberly A Koester, John A Sauceda, Xavier A Erguera, Kaylin Dance, Manami Diaz Tsuzuki, Matthew D Hickey, Andrew D Kerkhoff, Torsten B Neilands, Ingrid Eshun-Wilson, Elvin Geng, Katerina A Christopoulos

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引用次数: 0

Abstract

Background: Long-acting injectable cabotegravir and rilpivirine (CAB/RPV-LA) may overcome adherence barriers and provide treatment choice among people with HIV (PWH). However, little is known about the factors most likely to facilitate CAB/RPV-LA use.

Methods: We conducted a discrete choice experiment (DCE) at three urban U.S. HIV clinics, stratified by care engagement status (sub-optimal care engagement defined as most recent HIV RNA ≥200 copies/mL or <2 primary care visits with no HIV RNA measurement in past year). The DCE had 6 attributes: visit location, conversation with one's HIV provider at injection, extra support services, visit length, extended hours, and cost. We used mixed logit regression to estimate preference weights and latent class analysis to identify preference groupings. We examined associations between covariates, attribute preferences and latent class groups, and estimated shares of preference towards hypothetical scenarios.

Results: Between December 2021 - May 2022, 370 PWH participated. Median age was 46, 34% were cisgender female/gender minority, 59% African American/Black, 13% Latino/a/x, 34% experienced unstable housing, 19% endorsed illicit substance use, and 27% sub-optimal engagement. Cost and visit location were the most important attributes. Latent class analysis identified three groups: 1) cost-conscious (44%), 2) location-driven (34%), and 3) provider/support services-oriented (22%). Sub-optimally engaged PWH preferred extra support services. Shares of preference suggested a predicted use of CAB/RPV-LA exceeding 80% across delivery scenarios with more preferred features.

Conclusion: Participants strongly preferred CAB/RPV-LA delivery at no cost and accessible at their current HIV clinic. Preferences of PWH with sub-optimal engagement were heterogeneous, suggesting the need for tailored, differentiated delivery programs offering choice.

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确定三家美国HIV诊所长效注射卡波特韦-利普韦林的首选项目交付属性：离散选择实验。

背景：长效注射卡波特韦和利匹韦林（CAB/RPV-LA）可能克服依从性障碍，为HIV感染者（PWH）提供治疗选择。然而，对于最有可能促进CAB/RPV-LA使用的因素知之甚少。方法：我们在美国三个城市HIV诊所进行了离散选择实验（DCE），按护理参与状态(次优护理参与定义为最近的HIV RNA≥200拷贝/mL或结果：在2021年12月至2022年5月期间，370名PWH参与。中位年龄为46岁，34%为顺性别女性/少数性别，59%为非洲裔美国人/黑人，13%为拉丁裔/a/x， 34%经历过不稳定的住房，19%认可非法药物使用，27%为次优参与。成本和访问地点是最重要的属性。潜在类别分析确定了三个群体：1)成本意识（44%），2)位置驱动（34%），3)供应商/支持服务导向（22%）。次优聘聘的PWH更喜欢额外的支援服务。偏好份额表明，在具有更多首选功能的交付场景中，CAB/RPV-LA的预期使用率超过80%。结论：参与者强烈倾向于在他们目前的HIV诊所免费提供CAB/RPV-LA。次优参与的PWH的偏好是不同的，这表明需要量身定制，差异化的交付方案，提供选择。

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

JAIDS Journal of Acquired Immune Deficiency Syndromes 医学-传染病学

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.