Awareness of HIV functional cure and willingness in participating in related clinical trials: comparison between antiretroviral naïve and experienced men who have sex with men living with HIV

Abstract

Background Human immunodeficiency virus (HIV) functional cure is a novel biomedical strategy characterized by sustained viral suppression without the need for life-long medications. The attitude of people living with HIV (PLHIV) towards functional cure and clinical trials are understudied. We aimed to examine the awareness and levels of anticipation for HIV functional cure among men who have sex with men (MSM) living with HIV, and their willingness to join trials as differentiated by their antiretroviral treatment status. Methods MSM living with HIV with and those without treatment history were recruited from Hong Kong’s HIV specialist clinics. Self-administered questionnaires covering behavioral profile, perceived impact of HIV cure, attitude towards HIV functional cure and related clinical trials were collected. Clinical data were separately transcribed. Determinants of perceptions and attitudes were identified by logistic regression models. Results Of 356 MSM living with HIV recruited, less than half (42%) were aware of HIV functional cure, but they had a high level of anticipation for it. Treatment-experienced participants were more likely to be aware of HIV functional cure. Awareness was associated with continued engagement in sexual activities after HIV diagnosis and sexually transmitted infection (STI) diagnosis. Higher anticipation was observed among older MSM living with HIV but it was negatively associated with one’s awareness. Over 90% were willing to join functional cure trials, especially those who had previously been diagnosed with STI and had engaged in chemsex in the past year. Advice from healthcare professional was an important factor considered by those willing to join clinical trials. Younger, better educated MSM, and those with lower CD4 counts were more concerned about potential risk of AIDS and potential complications upon trial participation. Conclusions MSM living with HIV, especially those sexually active, showed positive attitude towards functional cure and willingness to join related clinical trials despite low awareness. To enhance preparedness for HIV functional cure trials, community education, updated information and appropriate medical advice would be needed. Safety is a major concern for potential enrollees in HIV functional cure trials.

Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta‐analysis

“…The 49 included studies [ 16 , 21 , 52 , 53 , 54 , 55 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 ] were published between 2009 and 2022 and recruited 46,157 MSM participants from 10 East and/or South Asian countries. Studies were conducted in China ( n = 20), Hong Kong ( n = 10), Thailand ( n = 6), Malaysia ( n = 4), multiple Asian countries ( n = 2), Cambodia ( n = 1), Indonesia ( n = 1), Japan ( n = 1), Taiwan ( n = 1), Singapore ( n = 1) and Vietnam ( n = 1).…”

“…The 49 included studies [16, 21, 52–55, 60–99] were published between 2009 and 2022 and recruited 46,157 MSM participants from 10 East and/or South Asian countries. Studies were conducted in China ( n = 20), Hong Kong ( n = 10), Thailand ( n = 6), Malaysia ( n = 4), multiple Asian countries ( n = 2), Cambodia ( n = 1), Indonesia ( n = 1), Japan ( n = 1), Taiwan ( n = 1), Singapore ( n = 1) and Vietnam ( n = 1).…”

HIV cure: an acceptability scientific agenda

“…Few studies have examined the specific question of desirability of functional cure. In a study involving 356 men who have sex with men (MSM) in Hong Kong, Kwan et al [ 6 ▪▪ ] showed that although 58% of participants were not aware of functional cure, when it was explained to them, 90% were willing to participate in long-term remission trials. In qualitative interviews done in Australia, Netherlands, South Africa or USA, participants envision cure as being a virus-free state.…”

“…Although antiretroviral therapy (ART) has been revolutionary in transforming HIV from a death sentence to a manageable chronic disease, it does not provide cure [ 1 , 2 , 3 ▪ , 4 , 5 , 6 ▪▪ , 7 ]. Patients must commit to lifelong medications and deal with issues such as incomplete viral suppression, social stigma, drug resistance, medication side effects and unsustainable costs.…”

Utilization of mental health services in relation to the intention to reduce chemsex behavior among clients from an integrated sexual health services center in Taiwan

“…The rise of this increasingly common practice has occurred alongside a boom in the popularity of dating applications on mobile phones, which facilitate meeting potential sex partners and accessing drugs [ 10 ]. The prevalence of chemsex in Asia is estimated at 11.1–11.8% among the general population of men who have sex with men (MSM) in Thailand, Hong Kong, and Malaysia [ 11 – 13 ], and it is estimated to be considerably higher among MSM living with HIV, at 38.9% in Taiwan [ 14 ] and 44.2% in Hong Kong [ 15 ]. It has been suggested that a large proportion of MSM who have engaged in chemsex in Taiwan have used methamphetamine at some point in their lives (27.1%), and among them 46% showed signs of methamphetamine dependency [ 5 ].…”