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Long-acting injectable (LAI) antiretroviral therapy (ART) represents a significant advancement in the management of HIV as these formulations can not only help improve outcomes, but also overcome several barriers associated with daily oral ART, such as adherence, privacy, and stigma. But despite these potential benefits, studies have revealed mixed feelings in terms of patients’ interest and acceptance. In fact, these feelings towards LAI ART may even differ by sex.

That’s why an abstract presented at the 2024 Conference on Retroviruses and Opportunistic Infections (CROI) sought to learn more about the various factors that might affect a patient’s preference for LAI versus oral ART.

In order to examine these factors and patient preferences, a cross-sectional survey was administered to 1,078 U.S. women with HIV between September 2020 and November 2021. This survey used a multinomial logistic regression method to assess and compare preferences based on age, race/ethnicity, income, education, adherence, and location.

Below are the demographic characteristics of the women who participated in the survey:

• The median age was 54
• 72 percent were Black and 13 percent were Hispanic
• 58 percent had an annual income of at least $12k
• 37 percent finished more than high school
• 88 percent reported at least 95 percent adherence to oral ART
• Locations included Atlanta, Birmingham, Jackson, Bronx, Brooklyn, Chapel Hill, Chicago, Miami, San Francisco, and Washington, D.C.

Overall, 43 percent of women preferred LAI ART, 36 percent preferred oral ART, and 21 percent were unsure.

Diving further into the results by examining patient preferences based on demographic characteristics, older women who reported high adherence to oral ART unsurprisingly preferred oral ART. Women in Miami also preferred oral ART whereas women in other cities preferred LAI ART.

Now when comparing women who preferred LAI ART versus those who were unsure, Hispanic women were more likely to prefer LAI ART. And comparing women who preferred oral ART versus those who were undecided, oral ART was preferred by women whose racial category was “other,” and LAI ART was preferred by women whose income was greater than or equal to $12k. Lastly, women in cities other than Miami were more likely to prefer LAI ART when compared to undecided women.

Based on these findings, researchers conclude that while about 20 percent remained unsure, there was an overall preference for LAI over oral ART, and these preferences were influenced by age, race/ethnicity, income, adherence, and location.

And so the researchers recommend tailoring education and support around LAI ART to ensure equitable access to treatment for all women with HIV, especially those who could potentially benefit from LAI ART based on their unique needs and experiences.

References:

Philbin MM, McCrimmon T, Collins LF, et al. Associations between interest in oral vs long-acting injectable art among US women with HIV - croi conference. CROI Conference. March 7, 2024. Accessed March 27, 2024. https://www.croiconference.org/abstract/associations-between-interest-in-oral-vs-long-acting-injectable-art-among-us-women-with-hiv/.