Patient Perspectives on Leveraging Long-Acting Injectable Antiretroviral Therapy Visits to Improve Chronic Disease Care.

Abstract

Long-acting injectable (LAI) antiretroviral therapy (ART) for treatment of HIV requires more frequent healthcare interactions than standard care, offering opportunities to enhance monitoring and management of comorbid chronic conditions among people with HIV (PWH). We conducted in-depth interviews with PWH to explore perspectives on LAI-ART uptake and readiness to switch from oral ART, as well as opportunities to integrate chronic disease care into routine LAI-ART visits. Participants who were virally suppressed and had one or more chronic medical conditions were eligible. Transcripts were analyzed using applied thematic analysis, and readiness for LAI-ART was characterized using the Transtheoretical Model. Twenty-four PWH were interviewed (8 on LAI-ART and 16 on oral ART). Perceived advantages of LAI-ART included logistical convenience and relief from pill-related emotional burden, while disadvantages included dislike of injections and increased visit frequency. Provider guidance played a central role in decision-making, and satisfaction with current regimens reduced interest in LAI-ART. All participants receiving LAI-ART intended to continue this regimen, and readiness to switch among those receiving oral ART ranged from little interest to actively planning a transition. Despite varied views on LAI-ART as a personal treatment choice, most participants viewed integrating chronic disease management into LAI-ART visits as acceptable and beneficial, particularly for cardiovascular risk assessments, mental health, and social needs. Some participants on oral ART reported that access to integrated services could increase openness to initiating LAI-ART. Overall, LAI-ART visits were viewed as a potentially valuable platform for integrating chronic disease management that aligns with patient priorities.