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 Kids Vitamins 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 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 Gas Wash/Dry Combo 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 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).