“A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania

Abstract

Background Long-acting injectable antiretroviral therapy (LA ART) was found to be non-inferior to daily oral ART in Phase 3 clinical trials. LA ART may offer an important alternative for people living with HIV with challenges adhering to daily oral ART or preferences for non-pill-based regimens. Methods Using a mixed methods approach integrating survey, in-depth interview and biological data from female sex workers (FSW) living with HIV in Tanzania (N = 208) and the Dominican Republic (DR) (N = 201), we assessed factors associated with the potential likelihood of LA ART use if it were available. We conducted multivariate logistic regression and thematic content analysis. Results Likelihood of LA ART use was high with 84.92% of FSW from the DR and 92.27% of FSW from Tanzania reporting they would be "likely" or "very likely" to use LA ART if available (p = 0.02). In Tanzania better HIV-related patient-provider communication (AOR 4.58; 95% CI 1.90-11.05) and quality of HIV clinical care (AOR 3.68; 95% CI 1.05-12.86) were positively

The Promise of Improved Adherence With Long-Acting Antiretroviral Therapy: What Are the Data?

“… 53 This interest persists outside of the US, one study of 409 female sex workers found that 92% of participants in Tanzania and 85% of participants in Dominican Republic would be very likely or likely to use a LA ART. 54 In qualitative interviews and surveys, participants cited discretion, convenience, confidentiality, reducing pill burden, removing fear of missed dosing, and avoiding daily reminders of living with HIV which led to a feeling of normalcy. 51 , 55 , 56 …”

Patient-Reported Outcomes Through 1 Year of an HIV-1 Clinical Trial Evaluating Long-Acting Cabotegravir and Rilpivirine Administered Every 4 or 8 Weeks (ATLAS-2M)

“…These challenges can impact the likelihood of treatment failure, with poor adherence to antiretroviral therapy linked to the emergence of resistance and virologic failure [7][8][9][10]. Consequently, there is considerable interest across a range of patient demographics in long-acting therapies, in particular, injectable long-acting therapies, which may help to alleviate some of the challenges associated with daily oral therapy [11][12][13][14][15].…”

Probing the Processes: Longitudinal Qualitative Research on Social Determinants of HIV

“…The analytic summary is a living document that includes basic socio-demographic data and baseline viral load followed by these sections: (1) an HIV narrative summary; (2) key quotes and themes related to stigma and social cohesion; (3) summary of topical modules Section within analytic summaries indexed data from topicspecific modules (long-acting injectable anti-retroviral therapy (ART), mindfulness, mobility). This facilitated efficient review of topical information while keeping the data within the overall context of the participant Example: mixed methods analysis of perceptions and attitudes of long-acting injectable ART at baseline [26] Coding Labeled thematic content systematically using software Used in conjunction with indices Example: for an analysis of the residential experiences of people returning from prison, excerpts labeled with the index "housing" were further coded with sub-codes related to types of residences (halfway houses, homeless shelter, etc.) in Nvivo…”

“…mobility, perceptions of long acting injectable ART, mindfulness) Follow-up questions to clarify content from previous interviews and probe on emergent areas Indexing Identified large sections of text by topic Facilitated easy retrieval of information 20 indices related to main study domains applied to transcripts in Nvivo Facilitated development of codes and writing of analytical memos Section within analytic summaries indexed data from topic-specific modules (long-acting injectable anti-retroviral therapy (ART), mindfulness, mobility). This facilitated efficient review of topical information while keeping the data within the overall context of the participant Example: mixed methods analysis of perceptions and attitudes of long-acting injectable ART at baseline [ 26 ] Coding Labeled thematic content systematically using software Used in conjunction with indices Example: for an analysis of the residential experiences of people returning from prison, excerpts labeled with the index “housing” were further coded with sub-codes related to types of residences (halfway houses, homeless shelter, etc.) in Nvivo Codes were developed to label sections of the HIV narrative elicited in baseline interviews including diagnosis, disclosure, initiating care/treatment.…”