Long-acting injectable antiretroviral treatment: experiences of people with HIV and their healthcare providers in Uganda
Long-acting injectable antiretroviral treatment: experiences of people with HIV and their healthcare providers in Uganda
Blog Article
Abstract Introduction Long-acting injectable antiretroviral treatment (LAI-ART) has emerged as a novel alternative to the burden of daily oral pills.The bi-monthly intramuscular injectable containing cabotegravir and rilpivirine holds the promise of improving adherence to ART.The perspectives of potential users of LAI-ART, the majority of whom reside in Eastern and Southern Africa, are still largely unexplored.
We set out to understand the experiences of people with HIV (PWH) who received LAI-ART at Fort Portal Regional Referral Hospital in mid-Western Uganda for at least 12 months.Methods This qualitative study, conducted between July and August 2023, was nested within a larger study.We conducted four focus groups with 32 (out of 69) PWH who received intramuscular injections of cabotegravir and rilpivirine.
In-depth interviews were held with six health workers who delivered LAI-ART to PWH.Data were analyzed by thematic approach broadly modeled on the five domains of the Consolidated Framework for Implementation Research (CFIR).Results There was high acceptability of LAI-ART (30 /32 or 94%) participants requested to remain on LAI-ART even after the end of the Clothing - Womens Bottoms - Shorts 12-month trial.
Adherence to ART was reportedly improved when compared to daily oral treatment.Participants credited LAI-ART with; superior viral load suppression, redemption from the daily psychological reminder of living with HIV, enhanced privacy in HIV care and treatment, reduced HIV-related stigma associated with taking oral pills and that it absolved them from carrying bulky medication packages.Conversely, nine participants reported pain around the injection site and a transient fever soon after administering the injection as side effects of LAI-ART.
Missed appointments for receiving the bi-monthly injection were common.Providers identified health system barriers to the prospective scale-up of LAI-ART which include the perceived high cost of LAI-ART, stringent cold chain requirements, physical space limitations, and workforce skills gaps in LAI-ART delivery as potential drawbacks.Conclusion Overall, PWH strongly preferred LAI-ART and expressed a comparatively higher satisfaction with this treatment alternative.
Health system barriers to potential scale-up are essential to consider if Serveware a broader population of PWH will benefit from this novel HIV treatment option in Uganda and other resource-limited settings.Trial registration Trial Registry Number PACTR ID PACTR202104874490818 (registered on 16/04/2021).