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治疗转换:对HIV感染者及利益相关者从口服抗逆转录病毒疗法转换为长效注射抗逆转录病毒疗法的偏好和障碍的系统评价与元聚合分析

Transitions in treatment: A systematic review and meta-aggregation of preferences and barriers in switching from oral to long-acting injectable antiretroviral therapy among people living with HIV and stakeholders.

作者信息

Hu Tiantian, Yang Shuqi, Yu Junwen, Yang Zhongfang, Jin Yilin, Zhu Zheng

机构信息

Fudan University School of Nursing, Shanghai, China.

Rory Meyers College of Nursing, New York University, New York, New York, USA.

出版信息

HIV Med. 2025 Apr;26(4):512-535. doi: 10.1111/hiv.13756. Epub 2025 Jan 2.

Abstract

INTRODUCTION

Antiretroviral treatment (ART) has significantly enhanced health outcomes for people living with HIV (PLWH). With the evolution of treatment options, there is an increasing interest in the development of long-acting injectable formulations of antiretroviral drugs. These formulations present a promising alternative to oral ART.

METHODS

The methodology and reporting of this systematic review followed the guidance of the Joanna Briggs Institute Reviewer's Manual and Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). The comprehensive searches involved multiple databases, including PubMed, MEDLINE (Ovid), Embase (Ovid), CINHAL (EBSCO), ProQuest Dissertations and Theses, Web of Science, Wanfang (Chinese), CNKI (Chinese), Google Scholar and Baidu Scholar (Chinese).

RESULTS

In all, 142 studies were identified and 20 eligible studies were included in the meta-aggregation. A total of 141 findings, 20 categories and nine synthesized findings were extracted from 20 studies. The nine synthesized findings identified from the 20 studies focused on the following topics: benefits, flexibility and practicality of long-acting injectable (LAI) treatment; scepticism about the use of LAI treatment; management challenges; logistical challenges; potential for protecting marginalized populations; concerns about side effects; financial issue; suggestions for improvement. PLWH's geographical distribution, backgrounds, demographics and clinical characteristics were limited.

CONCLUSION

We recommend considering the needs and experiences of PLWH in the transition from oral ART to LAI treatment. For marginalized populations, it is crucial to maintain regular communication with healthcare providers and institutions. Additionally, at the community level, engaging diverse stakeholders with valuable insights is vital, as is enhancing health education programmes and intensifying efforts to combat discrimination. These measures will play a key role in addressing the needs of PLWH, enhancing public awareness and promoting better understanding of LAI treatment.

摘要

引言

抗逆转录病毒治疗(ART)显著改善了艾滋病毒感染者(PLWH)的健康状况。随着治疗方案的不断发展,人们对抗逆转录病毒药物长效注射制剂的研发兴趣日益浓厚。这些制剂为口服抗逆转录病毒治疗提供了一种有前景的替代方案。

方法

本系统评价的方法和报告遵循了乔安娜·布里格斯研究所审稿手册以及《提高定性研究综合报告透明度》(ENTREQ)的指导。全面检索涉及多个数据库,包括PubMed、MEDLINE(Ovid)、Embase(Ovid)、CINHAL(EBSCO)、ProQuest学位论文数据库、科学引文索引、万方(中文)、中国知网(中文)、谷歌学术和百度学术(中文)。

结果

共识别出142项研究,20项符合条件的研究纳入了元聚合分析。从20项研究中总共提取了141项研究结果、20个类别和9项综合研究结果。从这20项研究中确定的9项综合研究结果集中在以下主题:长效注射(LAI)治疗的益处、灵活性和实用性;对LAI治疗使用的怀疑态度;管理挑战;后勤挑战;保护边缘化人群的潜力;对副作用的担忧;财务问题;改进建议。PLWH的地理分布、背景、人口统计学和临床特征有限。

结论

我们建议在从口服抗逆转录病毒治疗向LAI治疗过渡时考虑PLWH的需求和经历。对于边缘化人群,与医疗保健提供者和机构保持定期沟通至关重要。此外,在社区层面,让具有宝贵见解的不同利益相关者参与进来至关重要,加强健康教育计划和加大打击歧视的力度也同样重要。这些措施将在满足PLWH的需求、提高公众意识和促进对LAI治疗的更好理解方面发挥关键作用。

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