A Conjoint Analysis of the Acceptability of Targeted Long-Acting Injectable Antiretroviral Therapy Among Persons Living with HIV in the U.S.

TitleA Conjoint Analysis of the Acceptability of Targeted Long-Acting Injectable Antiretroviral Therapy Among Persons Living with HIV in the U.S.
Publication TypePublication
Year of Publication2020
AuthorsSimoni JM, Tapia K, Lee S-J, Graham SM, Beima-Sofie K, Mohamed ZH, Christodoulou J, Ho R, Collier AC
JournalAIDS Behav
Date Published2020 Apr
KeywordsAnti-Retroviral Agents, Black or African American, Delayed-Action Preparations, Female, Hispanic or Latino, HIV Infections, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Text Messaging

<p>With long-acting injectable antiretroviral therapy likely to be a treatment option for people living with HIV (PLWH), it is critical to assess its acceptability among potential end-users. Based on formative qualitative work and our own ongoing development of targeted long-acting products in nanosuspension formulations, we created eight hypothetical medication scenarios varying along six dichotomous attributes: administration location (home versus [vs.] clinic), dosing frequency (every 2 weeks vs. 1 week), injections per dose (one vs. two), injection pain (mild vs. moderate), injection site reaction (mild vs. moderate), and effectiveness (better vs. same as pills). PLWH from three outpatient care clinics in Seattle, WA and Riverside, CA rated acceptability (i.e., willingness to try each hypothetical medication) from 0 (very unlikely) to 100 (very likely). In conjoint analyses, we examined level and correlates of acceptability, the impact of each attribute on overall acceptability, and moderators of this effect. Participants (median age 52 years; 71% male, 34% White, 36% Black/African American, 20% Hispanic) rated acceptability of the 8 scenarios from 47.8 (standard deviation [SD] = 37.0) to 68.8 (SD = 34.1), with effectiveness (impact score = 7.3, SD = 18.7, p = 0.005) and dosing frequency (impact score = 5.7, SD = 19.6, p = 0.034) the only attributes with a significant impact on acceptability. There were no statistically significant differences in overall acceptability according to any participant socio-demographic or other characteristic; however, gender, education, employment status, and experience with and hatred/avoidance of injections moderated some effects. Overall acceptability for targeted long-acting antiretroviral treatment as proposed was modest, with superior effectiveness and lower dosing frequency most impactful on acceptability. Future acceptability research should continue to evaluate specific products in development with a full range of conjoint analytic and other techniques.</p>

Alternate JournalAIDS Behav
PubMed ID31655915
PubMed Central IDPMC7085450
Grant ListP30 MH058107 / MH / NIMH NIH HHS / United States
UM1 AI120176 / AI / NIAID NIH HHS / United States
R33 AI149665 / AI / NIAID NIH HHS / United States
P30 AI027757 / AI / NIAID NIH HHS / United States