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• W4321235715 abstract "Youth with HIV (YHIV) aged 13-25 often struggle with adherence to oral daily antiretroviral treatment (ART) regimens. Recently approved intramuscular (IM) injectable long-acting ART (LA-ART) may play a role in optimizing adherence and improving longitudinal health outcomes. Other novel formulations and delivery methods not yet commercially available may also be preferable to daily pills for YHIV. The study explores the willingness to use LA-ART strategies among YHIV who are not virally suppressed due to adherence challenges. This human subjects’ approved pilot, cross-sectional study as a telephonic-based survey was embedded into a randomized controlled trial at the end of a technology-enhanced community health nursing intervention (NCT03600103) designed to enhance viral suppression among YHIV with baseline adherence challenges and baseline detectable viremia. Participants completed 34-item telephone surveys between October 2021 and February 2022 to evaluate patient preferences and willingness to use four LA-ART delivery alternatives (IM, subcutaneous injection (SC), the subdermal implant (SDI), and LA-ART pills) compared to daily oral ART. Participant responses were summarized using descriptive statistics, including proportions for categorical responses and median and ranges for potentially skewed factors such as age and viral load (VL). Fisher’s exact tests were used to compare willingness to try LA-ART across patient characteristics. Of the 19 participants enrolled in the sub-study, 47% were male (n=9), 42% female (n=8), 11% transgender female (n=2), 79% were African American, and the median age was 23 years (range 15-26 years). Twenty-six percent (5/19) reported having missed their HIV medications at least once within the prior four days. Fifty-three percent (10/19) of participants’ most recent VL was undetectable (< 20 copies/mL) at survey completion. Overall there was high interest in willingness to try LA-ART, 70% (7/10) of those with undetectable VL and 89% (8/9) of those with detectable VL (>=20 copies/mL), (p=0.582). Regarding specific LA-ART delivery preferences, long-acting pills had the highest preference (84%, 16/19), while 79% of participants (15/19) expressed willingness to try IM (15/19), 79% (15/19) SC, and 74% (14/19) SDI. However, when asked to choose only one method, most (58%, 11/19) selected IM as the method that would work best for them. The arm was the preferred injection site (73% [8/11]) compared to the thigh (18% [2/11]) (the site of administration of currently approved injectable LA-ART) for the IM injection. About half (47% [9/19]) reported being willing to self-administer injections. Willingness to use LA-ART was generally higher with less frequent injections; e.g., for IM LA-ART, 47% (9/19) were willing to try weekly vs. 79% (15/19) were willing to try every three-month injections. Finally, 89% (17/19) endorsed that having a different route of taking medications would be essential for keeping their medication use private. YHIV experiencing adherence challenges are willing to use novel LA-ART delivery methods. As new methods are approved, contingent valuation studies with larger, heterogeneous samples of YHIV may better define the acceptability and the predicted uptake of LA-ART methods toward designing a public health implementation strategy for YHIV." @default.
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• W4321235715 date "2023-03-01" @default.
• W4321235715 modified "2023-09-25" @default.
• W4321235715 title "129. Understanding the Translational Potential of Advances in HIV Leveraging Consumer Preferences for Care: Long-Acting Antiretroviral Treatment for Youth with HIV" @default.
• W4321235715 doi "https://doi.org/10.1016/j.jadohealth.2022.11.151" @default.
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