By: Kenyon Farrow https://www.thebodypro.com/article/long-acting-hiv-meds-are-acceptable-to-many-people-but-differences-exist-among-groups
Now that long-acting antiretroviral therapy (LA-ART) is almost a reality, is it something people with HIV will prefer over once-a-day pills? A study presented during a poster session at the International Conference on HIV Treatment and Prevention sought to determine whether LA-ART was as acceptable as daily pill treatment among 374 people living with HIV at a clinic in Houston. While they found that overall, LA-ART was acceptable to most people, it was not equally acceptable across all groups.
The researchers conducted this study as a survey of 374 participants at a Houston clinic who agreed to complete it and have their medical records reviewed for demographic and medical history information. Participants were asked to select their preferred treatment modality if all options cost the same and were equally effective. The average age was 49, and the majority were U.S.-born, male (64%), and Black (63%).
More than 60% of all participants said they were very likely to use a new long-acting antiretroviral therapy (LA-ART) if one became available, compared to 39% who said they were less likely to use one. When asked which method they preferred, 41% preferred pills, 40% a long-acting injectable, and only 18% preferred a long-acting implant. Nearly three-quarters of all respondents thought the benefit of LA-ART would be not having to remember to take daily pills, although 43% were concerned that long-acting options would work less well than pill-based ART.
"What's interesting that we didn't expect is that many people want to try [LA-ART], but when forced to choose the best method for taking their medication, 41% still wanted pills," said Dima Dandachi, MD, lead researcher of the study, which was conducted at Baylor University.
When researchers further analyzed which variables were associated with the desire to switch to LA-ART, those with some form of college education and those who were gay or bisexual, who were receiving antiretroviral treatment twice a day, or who had difficulty scheduling or attending clinical appointments, preferred the longer-term treatment options.
"I think in their minds, long-acting injectables will be easier to take than a daily pill, but they don't know that they may have to inject themselves at the clinic every month," Dandachi said.
The National Institutes of Health (NIH) announced in May that it will fund the LATITUDE study, which will seek to determine the superiority of the monthly long-acting injectable cabotegravir/rilpivirine over the ART pill for people who struggle to maintain a daily pill regimen.
“Monthly injectable antiretroviral therapy may be more convenient, discreet, and appropriate for some people living with HIV,” said Aadia Rana, MD, associate professor of medicine at the University of Alabama at Birmingham Center for AIDS Research and co-chair of the LATITUDE protocol, in an NIH news release. “Our study aims to help people living with HIV who face adherence challenges find a treatment option that meets their health needs and fits into their lives, allowing them to experience the health benefits of becoming long-lasting viral suppressants.”
Regardless of the LATITUDE results, the healthcare system for people living with HIV may not be prepared to handle even a small proportion of those who choose to use LA-ART. TheBodyPro reported in April on a talk given by Melanie Thompson, MD, of the AIDS Research Consortium of Georgia, during which she detailed the systemic challenges that must be addressed to make LA-ART a reality for people who want to change.