Antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) are key strategies in ending the HIV epidemic. However, poor adherence to daily ART and PrEP increases the risk of HIV transmission and acquisition. Long-acting ART and PrEP formulations attempt to improve adherence through providing long-lasting forms of the medication delivered through different routes of administration: oral (potentially monthly), injection (1–6 months), and subdermal implant (up to annually). This study explored patient and physician preferences for long-acting ART and PrEP as well as adherence support strategies. Adult patients (n = 42) with experience taking ART or PrEP participated in individual interviews or focus groups. Physicians (n = 13) currently prescribing ART and/or PrEP completed an online questionnaire. Rapid qualitative analysis systematically synthesized qualitative data, and descriptive statistics examined survey responses. Patients supported improved adherence as a top potential advantage of long-acting ART and PrEP, and reduced internal stigma as a strong benefit specific to long-acting ART. Annual coverage offered through subdermal implants had strong appeal; however, oral was the preferred modality for long-acting ART and PrEP. Patients preferred injectable ART and PrEP if concurrently receiving hormone therapy injections. Side effects, medication cost, and treatment accessibility were potential barriers. Patients preferred calendar tracking and text messages/phone reminders for adherence supports. Physicians reported that they would reduce clinic visits and HIV testing for all patients on long-acting PrEP, except men who have sex with men who would continue to complete HIV testing every 3 months. Physicians were mixed on whether they believed long-acting ART and PrEP would improve patient adherence. Overall, findings demonstrate the potential benefits of long-acting ART and PrEP, while highlighting the need to obtain additional information to address treatment concerns.

中文翻译：

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患者和医生对长效暴露前预防和抗逆转录病毒治疗的偏好：美国南加州的一项混合方法研究


抗逆转录病毒治疗（ART）和暴露前预防（PrEP）是结束艾滋病毒流行的关键策略。然而，日常 ART 和 PrEP 依从性差会增加 HIV 传播和感染的风险。长效 ART 和 PrEP 制剂试图通过不同的给药途径提供长效药物形式来提高依从性：口服（可能每月一次）、注射（1-6 个月）和皮下植入（最多每年一次）。这项研究探讨了患者和医生对长效 ART 和 PrEP 的偏好以及依从性支持策略。有接受 ART 或 PrEP 经验的成年患者 ( n = 42) 参加了个人访谈或焦点小组。目前正在开 ART 和/或 PrEP 处方的医生 ( n = 13) 完成了在线调查问卷。快速定性分析系统地综合了定性数据，描述性统计检查了调查答复。患者支持提高依从性作为长效 ART 和 PrEP 的最大潜在优势，并减少内部耻辱作为长效 ART 特有的强大益处。通过皮下植入提供的年度保险具有很强的吸引力；然而，口服是长效 ART 和 PrEP 的首选方式。如果同时接受激素治疗注射，患者更喜欢注射 ART 和 PrEP。副作用、药物成本和治疗可及性是潜在的障碍。患者更喜欢日历跟踪和短信/电话提醒来获得依从性支持。医生报告说，他们将减少所有接受长效 PrEP 的患者的门诊次数和 HIV 检测，但男男性行为者除外，他们将继续每 3 个月完成一次 HIV 检测。 医生们对于长效 ART 和 PrEP 是否会提高患者依从性的看法不一。总体而言，研究结果证明了长效 ART 和 PrEP 的潜在益处，同时强调需要获取更多信息来解决治疗问题。