Who could benefit the most from long-acting antiretroviral therapy? perspectives of HIV care providers and people with HIV in Florida.

Abstract

Injectable cabotegravir/rilpivirine (CAB/RPV) is now available, and other long-acting antiretroviral therapy (ART) regimens are in development. The present study describes the factors that HIV care providers and people with HIV (PWH) in Florida (a high HIV incidence and prevalence setting) consider when assessing populations of PWH who could benefit from long-acting ART. We conducted semi-structured qualitative interviews with 11 providers (27% non-Hispanic Black, 27% Hispanic, 73% cis women) and 16 PWH (31% non-Hispanic Black, 19% Hispanic, 50% cis men, 69% aged 50+) from five sites in Florida. Participants were asked about the groups of PWH who they thought could benefit the most from long-acting ART. Responses were analyzed using a reflexive thematic approach. Seven populations of PWH who could benefit from long-acting ART were identified: 1) younger PWH, 2) PWH with co-occurring conditions, 3) PWH who use substances, 4) PWH experiencing housing instability, 5) PWH with frequent travel, 6) PWH experiencing stigma, and 7) PWH who reliably take medication and engage in care. Many groups who may be excluded from injectable CAB/RPV based on the current guidelines were seen as potentially benefiting from such an option.