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Feasibility of Implementing Long-Acting Injectable Antiretroviral Therapy to Treat HIV: A Survey of Health Providers from the 13 Countries Participating in the ATLAS-2M Trial
AIDS Research and Human Retroviruses ( IF 1.5 ) Pub Date : 2021-03-05 , DOI: 10.1089/aid.2020.0208
Deanna Kerrigan 1 , Miranda Murray 2 , Tahilin Sanchez Karver 1, 3 , Andrea Mantsios 4 , Nicki Walters 5 , Krischan Hudson 6 , Emma Kaplan-Lewis 7 , Federico Pulido 8 , Ayesha Cassim Bassa 9 , David Margolis 6 , Noya Galai 3
Affiliation  

Long-acting (LA) injectable antiretroviral therapy (ART) was found noninferior to daily oral ART in Phase 3 trials with high patient satisfaction. Limited information on provider experiences with LA ART exists, which is critical to inform real-world implementation. An online survey of health providers from the 13 countries participating in the Phase 3b ATLAS-2M trial was conducted. A total of 293 providers responded to questions on LA ART feasibility. Multivariable regression was utilized to identify factors related to the feasibility of LA ART every month and every 2 months within routine care such as the characteristics, experiences, and attitudes of providers, and perceptions of patient benefits and barriers. A majority of providers indicated that it would be very feasible (62.8%) or somewhat feasible (32.1%) to administer monthly LA ART. Feasibility scores were higher for delivering LA ART every 2 months versus monthly (mean 28.3 vs. 26.9; p value <.001). African providers had higher odds of perceived overall feasibility of monthly LA ART [adjusted odds ratio (aOR) 2.9, 95% confidence interval (CI) 1.9–4.4] versus those from other regions, as did providers reporting a greater number of benefits for patients (aOR 1.1, 95% CI 1.0–1.1) versus those reporting less. Providers reporting a greater number of patient barriers to adhere to clinic appointments had lower odds of perceived feasibility of monthly LA ART (aOR 0.8, 95% CI 0.7–1.0) versus those reporting less. Findings highlight the need for further implementation research regarding barriers, facilitators, and strategies to optimize the introduction of LA ART outside of clinical trials.

中文翻译:

实施长效注射抗逆转录病毒疗法治疗 HIV 的可行性:对参与 ATLAS-2M 试验的 13 个国家的卫生提供者的调查

在具有高患者满意度的 3 期试验中,长效 (LA) 可注射抗逆转录病毒疗法 (ART) 被发现不劣于每日口服 ART。关于提供者在 LA ART 方面的经验的信息有限,这对于告知现实世界的实施至关重要。对参与 3b 期 ATLAS-2M 试验的 13 个国家的卫生提供者进行了在线调查。共有 293 名提供者回答了有关 LA ART 可行性的问题。多变量回归用于确定与常规护理中每月和每 2 个月 LA ART 可行性相关的因素,例如提供者的特征、经验和态度,以及对患者利益和障碍的看法。大多数提供者表示每月进行 LA ART 非常可行 (62.8%) 或有些可行 (32.1%)。p值 <.001)。与来自其他地区的提供者相比,非洲提供者认为每月 LA ART 的总体可行性[调整后的优势比 (aOR) 2.9,95% 置信区间 (CI) 1.9-4.4] 的可能性更高,提供者报告的患者获益更多(aOR 1.1, 95% CI 1.0–1.1) 与报告较少的那些。与报告较少的提供者相比,报告有更多患者坚持诊所预约的障碍的提供者认为每月 LA ART 的可行性的可能性较低(aOR 0.8,95% CI 0.7-1.0)。研究结果强调需要进一步实施研究,以优化临床试验之外引入 LA ART 的障碍、促进因素和策略。
更新日期:2021-03-09
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