Fisk-Hoffman Rebecca J, Liu Yiyang, Somboonwit Charurut, Widmeyer Maya, Bilello Lori A, Cohen Colby, Leeman Robert F, Prosperi Mattia, Salloum Ramzi G, Cook Robert L
Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL.
Department of Internal Medicine, USF Health, University of South Florida, Tampa, FL.
J Acquir Immune Defic Syndr. 2025 May 1;99(1):87-92. doi: 10.1097/QAI.0000000000003609.
Florida remains a high-incidence, high-prevalence setting for HIV. Long-acting (LA) antiretroviral therapies (ART) could improve HIV-related outcomes and reduce transmission. This study identifies preferred LA ART characteristics and classes of preference among persons with HIV (PWH) in Florida.
The Florida Cohort enrolls adult PWH from 6 counties. In February 2023, a best-worst scaling discrete choice experiment was added that included 12 tasks with 3 alternatives and an opt-out (i.e., their current regimen). Six attributes were included: treatment type (e.g., shot), long-term effects, side effects, location (e.g., at home), effectiveness, and frequency. A Hierarchical Bayes model was used to estimate level utilities, attribute importance was calculated, and a latent class model was run in Sawtooth Software.
Overall, 208 PWH participated (60% aged 50+, 49% non-Hispanic Black, 54% male). Treatment type had the greatest impact on preference [27.2% (95% CI: 25.1 to 29.3)], followed by frequency [23.4% (95% CI: 21.6 to 25.2)], and long-term effects [19.0% (95% CI: 17.8 to 20.3)]. Within treatment type, LA pills were preferred over other options, including their current regimen. Less frequent administration was preferred, but only yearly administration was preferred over their current regimen. Within long-term effects, participants preferred no increase in risk. Two classes were identified where one class (27% of participants) preferred their current regimen and the other (73% of participants) preferred an alternative, placing greater importance on frequency.
PWH preferred LA pills and less frequent administration, so future ART development could focus on options with these traits. Further exploration of user preference classes is needed.
佛罗里达州仍然是艾滋病病毒（HIV）高发病率和高流行率的地区。长效抗逆转录病毒疗法（ART）可以改善与HIV相关的结果并减少传播。本研究确定了佛罗里达州HIV感染者（PWH）对长效ART的偏好特征和偏好类别。
佛罗里达队列研究招募了来自6个县的成年PWH。2023年2月，增加了一项最佳-最差尺度离散选择实验，其中包括12项任务，每项任务有3种选择和一个退出选项（即他们目前的治疗方案）。包括六个属性：治疗类型（如注射）、长期影响、副作用、给药地点（如在家）、有效性和给药频率。使用分层贝叶斯模型估计水平效用，计算属性重要性，并在Sawtooth软件中运行潜在类别模型。
总体而言，208名PWH参与了研究（60%年龄在50岁以上，49%为非西班牙裔黑人，54%为男性）。治疗类型对偏好的影响最大[27.2%（95%置信区间：25.1%至29.3%）]，其次是给药频率[23.4%（95%置信区间：21.6%至25.2%）]和长期影响[19.0%（95%置信区间：17.8%至20.3%）]。在治疗类型中，长效药丸比其他选择更受青睐，包括他们目前的治疗方案。给药频率较低更受青睐，但只有每年给药比他们目前的治疗方案更受青睐。在长期影响方面，参与者更喜欢风险不增加。确定了两个类别，其中一类（27%的参与者）更喜欢他们目前的治疗方案，另一类（73%的参与者）更喜欢替代方案，更重视给药频率。
PWH更喜欢长效药丸和给药频率较低的方案，因此未来的ART开发可以专注于具有这些特征的选项。需要进一步探索用户偏好类别。
