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
{"title":"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。","authors":"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","doi":"10.1097/QAI.0000000000003661","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445180/pdf/","citationCount":"0","resultStr":"{\"title\":\"Identifying preferred program delivery attributes for long-acting injectable cabotegravir-rilpvirine in three U.S. HIV clinics: A discrete choice experiment.\",\"authors\":\"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\",\"doi\":\"10.1097/QAI.0000000000003661\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":14588,\"journal\":{\"name\":\"JAIDS Journal of Acquired Immune Deficiency Syndromes\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-03-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445180/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAIDS Journal of Acquired Immune Deficiency Syndromes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAI.0000000000003661\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAIDS Journal of Acquired Immune Deficiency Syndromes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAI.0000000000003661","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Identifying preferred program delivery attributes for long-acting injectable cabotegravir-rilpvirine in three U.S. HIV clinics: A discrete choice experiment.
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.
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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