Saldarriaga Enrique M, Hauber Brett, Barthold Douglas, Brah Aaron T, Tran Jacinda, Marconi Vincent C, Simoni Jane M, Graham Susan M
The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, 1959 Pacific St NE, Seattle, WA, 98107, USA.
Pfizer, Inc, New York, NY, USA.
BMC Infect Dis. 2025 Feb 19;25(1):237. doi: 10.1186/s12879-025-10546-w.
Long-acting antiretroviral therapy (LA-ART) is an emerging alternative to daily oral ART pills that may improve HIV treatment adherence. We studied preference heterogeneity for LA-ART among people with HIV (PWH) in western Washington State and Atlanta, Georgia to determine how preference heterogeneity was related to individual characteristics.
We recruited 699 PWH to complete a survey including 17 choice-tasks, each of which included two hypothetical LA-ART alternatives and current daily oral therapy. Each hypothetical alternative was defined by mode (long-acting [LA] oral pills, subcutaneous injections, intramuscular injections, and implants), frequency, treatment location (home, clinic, or pharmacy), injection pain, pre-treatment time undetectable, pre-treatment reaction testing, and late-dose leeway. We fitted a latent class model to the data and investigated associations between class membership and individual characteristics.
Our sample had three classes which were defined by their treatment preferences. Two classes preferred LA-ART over current treatment: the LA-Implant class (29%) and the LA-Oral-or-Injection class (35%). In contrast, the Daily-or-LA-Oral class (36%) preferred current treatment or LA oral pills taken at home. Compared to the third class, participants from the other two were younger, more educated, less adherent to current ART, and less averse to injections. Further, LA-Implant participants were less likely to be virally suppressed and had easier clinic access. LA-Oral-or-Injection participants had a higher prevalence of psychotic disorders.
These results provide a deeper understanding of the preference landscape for LA-ART and can aid in the development of interventions better aligned with individual preferences.
长效抗逆转录病毒疗法（LA-ART）是每日口服抗逆转录病毒药物的一种新兴替代方案，可能会提高艾滋病毒治疗的依从性。我们研究了华盛顿州西部和佐治亚州亚特兰大的艾滋病毒感染者（PWH）对LA-ART的偏好异质性，以确定偏好异质性与个体特征之间的关系。
我们招募了699名PWH完成一项调查，其中包括17项选择任务，每项任务都包括两种假设的LA-ART替代方案和当前的每日口服疗法。每种假设的替代方案由给药方式（长效口服丸剂、皮下注射、肌肉注射和植入物）、频率、治疗地点（家中、诊所或药房）、注射疼痛、治疗前检测不到的时间、治疗前反应检测和后期剂量余量定义。我们对数据拟合了一个潜在类别模型，并研究了类别归属与个体特征之间的关联。
我们的样本有三个类别，由其治疗偏好定义。两个类别比当前治疗更喜欢LA-ART：LA-植入物类别（29%）和LA-口服或注射类别（35%）。相比之下，每日或LA-口服类别（36%）更喜欢当前治疗或在家服用的LA口服丸剂。与第三类相比，其他两类的参与者更年轻、受教育程度更高、对当前抗逆转录病毒疗法的依从性更低，并且对注射的厌恶程度更低。此外，LA-植入物参与者病毒抑制的可能性较小，并且更容易获得诊所服务。LA-口服或注射参与者精神疾病的患病率较高。
这些结果提供了对LA-ART偏好情况的更深入理解，并有助于开发更符合个体偏好的干预措施。
