Willingness to participate in clinical trials and expectations towards antiretroviral therapy among heavily treatment-experienced people living with HIV: A feasibility survey.

Introduction: As life expectancy among persons with HIV on antiretroviral therapy (ART) is increasing, comorbidities and polypharmacy increase. Drug-drug interactions (DDIs) are common among persons with HIV with a history of virological failure, since many are receiving boosted ART. We assessed the willingness of individuals with a history of virological failure on a boosted ART to participate in simplification trials and evaluated their expectations towards ART.

Methods: We conducted a cross-sectional survey among persons with HIV at five hospitals in Switzerland between October 2021 and July 2022. We collected data using quantitative paper-based questionnaires and analysed the data using descriptive statistics. Community representatives were involved in the study planning and conduct, and in the interpretation of findings.

Results: Overall, 143 (64%) of 223 eligible persons with HIV participated. Median age was 59 years (interquartile range [IQR] 52.5-63.5), 32 (22%) were female, median time on ART was 26 years (IQR: 20-27). Among participants, 104 (72%) would agree to participate in clinical trials aiming at evaluating simplified ART regimens with reduced DDI risks, or were still undecided. Of them, 92 (88%) were satisfied with their current treatment. Their main expectations about simplified ART were treatment efficacy (91%), fewer DDIs (83%), low pill number (78%) and forgiveness in case of missed doses (75%).

Conclusions: Persons with HIV and a history of virological failure were motivated to participate in clinical research. This underlines the importance of including them in future trials. Furthermore, conducting feasibility surveys and including persons with HIV in the study design prior to trials ensures their relevance and alignment with people's needs and expectations.