Alford Kate, Sidat Shiraaz, Bristowe Katherine, Cicconi Paola, Vera Jamie H, Cresswell Fiona
Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK.
Florence Nightingale Faculty of Nursing Midwifery & Palliative Care, Cicely Saunders Institute, King's College London, London, UK.
HIV Med. 2025 Mar;26(3):441-450. doi: 10.1111/hiv.13748. Epub 2024 Dec 10.
The twice-yearly, long-acting lenacapavir (LA LEN) antiretroviral therapy (ART), when combined with an optimised background regimen, provides a subcutaneous injectable treatment option for people with HIV. This study aimed to understand the preferences, barriers and facilitators for uptake and implementation of LA LEN, with a view to informing clinical implementation.
In-depth qualitative interviews and focus groups with purposively sampled people with HIV and healthcare workers (HCWs) from UK HIV services were conducted. Transcripts were analysed using summative and conventional content analysis.
Thirty-four people with HIV with varied ART experience were recruited from two HIV services. Participants included 22 (65%) identifying as cisgender men and 12 (35%) identifying as cisgender women; median age was 55 years (range 26-76 years). Fourteen HIV HCWs took part in three focus groups. Four key themes and 12 subthemes were identified: LA LEN as a treatment option; LA LEN versus oral ART; switching considerations; and administration of LA LEN. The majority (88%) of people with HIV were interested in switching to LA LEN if offered. Preference was markedly reduced if an oral ART pairing was required. Convenience of the dosing schedule, reduced pill burden and issues around stigma were reasons for interest in LA LEN, but concerns regarding efficacy, dosing interval windows, monitoring and side effects were described. HCWs felt the benefit of LA LEN was as a treatment option for those with adherence issues, drug resistance and a high pill burden. Broader use of LA LEN raised concerns over drug resistance, delivery capacity and storage.
LA LEN was viewed as a preferable treatment choice for many people with HIV, provided an all-injectable regimen was available. Feasibility assessments for provision of injectable ART and research on its potential for self-administration are needed.
每半年一次的长效来那卡韦（LA LEN）抗逆转录病毒疗法（ART）与优化的背景治疗方案联合使用时，为艾滋病毒感染者提供了一种皮下注射治疗选择。本研究旨在了解LA LEN采用和实施的偏好、障碍及促进因素，以便为临床实施提供信息。
对来自英国艾滋病毒服务机构的有目的地抽样的艾滋病毒感染者和医护人员（HCW）进行了深入的定性访谈和焦点小组讨论。使用总结性和传统内容分析法对访谈记录进行了分析。
从两个艾滋病毒服务机构招募了34名有不同抗逆转录病毒治疗经验的艾滋病毒感染者。参与者包括22名（65%）自我认定为顺性别男性和12名（35%）自我认定为顺性别女性；年龄中位数为55岁（范围26 - 76岁）。14名艾滋病毒医护人员参加了三个焦点小组。确定了四个关键主题和12个子主题：LA LEN作为一种治疗选择；LA LEN与口服抗逆转录病毒疗法；换药考虑因素；以及LA LEN的给药。大多数（88%）艾滋病毒感染者表示如果有机会愿意换用LA LEN。如果需要搭配口服抗逆转录病毒药物，偏好会明显降低。给药方案的便利性、减少的药片负担以及耻辱感相关问题是对LA LEN感兴趣的原因，但也有人提到了对疗效、给药间隔窗口、监测和副作用的担忧。医护人员认为LA LEN的好处在于它是那些存在依从性问题、耐药性和药片负担重的患者的一种治疗选择。LA LEN的更广泛使用引发了对耐药性、给药能力和储存的担忧。
如果能提供全注射方案，LA LEN被许多艾滋病毒感染者视为更优的治疗选择。需要对提供注射用抗逆转录病毒疗法进行可行性评估，并研究其自我给药的潜力。
