Perspectives on preparing for long-acting injectable treatment for HIV among consumer, clinical and nonclinical stakeholders: A qualitative study exploring the anticipated challenges and opportunities for implementation in Los Angeles County.
Long-acting injectable (LAI) antiretroviral therapy (ART) is a novel HIV treatment option for people with HIV. The first LAI ART regimen for HIV treatment received regulatory approval in the United States in January 2021. In February 2020, we collected qualitative data from 18 consumers and 23 clini...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0262926 |
| _version_ | 1811161597347889152 |
|---|---|
| author | Oluwadamilola Jolayemi Laura M Bogart Erik D Storholm David Goodman-Meza Elena Rosenberg-Carlson Rebecca Cohen Uyen Kao Steve Shoptaw Raphael J Landovitz |
| author_facet | Oluwadamilola Jolayemi Laura M Bogart Erik D Storholm David Goodman-Meza Elena Rosenberg-Carlson Rebecca Cohen Uyen Kao Steve Shoptaw Raphael J Landovitz |
| author_sort | Oluwadamilola Jolayemi |
| collection | DOAJ |
| description | Long-acting injectable (LAI) antiretroviral therapy (ART) is a novel HIV treatment option for people with HIV. The first LAI ART regimen for HIV treatment received regulatory approval in the United States in January 2021. In February 2020, we collected qualitative data from 18 consumers and 23 clinical and non-clinical stakeholders to catalog anticipated individual-consumer, healthcare system, and structural levels barriers and facilitators to LAI ART implementation in Los Angeles County, California. Thematic analysis was guided by the CFIR implementation science model. CFIR constructs of intervention characteristics, individual characteristics, outer and inner setting, intervention characteristics, and implementation process emerged in analysis. Under intervention characteristics, anticipated facilitators included the relative advantage of LAI ART over pills for adherence and reduced treatment management burden and related anxiety; anticipated barriers included non-adherence to injection appointments, concerns of developing HIV resistance, discomfort with injection and cost. Anticipated facilitators based on individual characteristics included overall acceptability based on knowledge and positive beliefs about LAI ART. Participant noted several characteristics of the outer setting that could negatively impact implementation, such as medical mistrust, external policies, and LAI ART eligibility (i.e., to be virally suppressed prior to initiation). Participants were optimistic about the potential to decrease stigma but expressed that provider willingness for adoption could be hindered by challenges in organizational inner setting related to payment authorizations, increased staffing needs, medication procurement and storage, and provider and healthcare system readiness. Results from this pre-implementation study may inform rollout and scale-up of LAI ART in Los Angeles County. |
| first_indexed | 2024-04-10T06:18:02Z |
| format | Article |
| id | doaj.art-0ba53f65482042a182e0c20cbd5c8ffa |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-10T06:18:02Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-0ba53f65482042a182e0c20cbd5c8ffa2023-03-02T05:32:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01172e026292610.1371/journal.pone.0262926Perspectives on preparing for long-acting injectable treatment for HIV among consumer, clinical and nonclinical stakeholders: A qualitative study exploring the anticipated challenges and opportunities for implementation in Los Angeles County.Oluwadamilola JolayemiLaura M BogartErik D StorholmDavid Goodman-MezaElena Rosenberg-CarlsonRebecca CohenUyen KaoSteve ShoptawRaphael J LandovitzLong-acting injectable (LAI) antiretroviral therapy (ART) is a novel HIV treatment option for people with HIV. The first LAI ART regimen for HIV treatment received regulatory approval in the United States in January 2021. In February 2020, we collected qualitative data from 18 consumers and 23 clinical and non-clinical stakeholders to catalog anticipated individual-consumer, healthcare system, and structural levels barriers and facilitators to LAI ART implementation in Los Angeles County, California. Thematic analysis was guided by the CFIR implementation science model. CFIR constructs of intervention characteristics, individual characteristics, outer and inner setting, intervention characteristics, and implementation process emerged in analysis. Under intervention characteristics, anticipated facilitators included the relative advantage of LAI ART over pills for adherence and reduced treatment management burden and related anxiety; anticipated barriers included non-adherence to injection appointments, concerns of developing HIV resistance, discomfort with injection and cost. Anticipated facilitators based on individual characteristics included overall acceptability based on knowledge and positive beliefs about LAI ART. Participant noted several characteristics of the outer setting that could negatively impact implementation, such as medical mistrust, external policies, and LAI ART eligibility (i.e., to be virally suppressed prior to initiation). Participants were optimistic about the potential to decrease stigma but expressed that provider willingness for adoption could be hindered by challenges in organizational inner setting related to payment authorizations, increased staffing needs, medication procurement and storage, and provider and healthcare system readiness. Results from this pre-implementation study may inform rollout and scale-up of LAI ART in Los Angeles County.https://doi.org/10.1371/journal.pone.0262926 |
| spellingShingle | Oluwadamilola Jolayemi Laura M Bogart Erik D Storholm David Goodman-Meza Elena Rosenberg-Carlson Rebecca Cohen Uyen Kao Steve Shoptaw Raphael J Landovitz Perspectives on preparing for long-acting injectable treatment for HIV among consumer, clinical and nonclinical stakeholders: A qualitative study exploring the anticipated challenges and opportunities for implementation in Los Angeles County. PLoS ONE |
| title | Perspectives on preparing for long-acting injectable treatment for HIV among consumer, clinical and nonclinical stakeholders: A qualitative study exploring the anticipated challenges and opportunities for implementation in Los Angeles County. |
| title_full | Perspectives on preparing for long-acting injectable treatment for HIV among consumer, clinical and nonclinical stakeholders: A qualitative study exploring the anticipated challenges and opportunities for implementation in Los Angeles County. |
| title_fullStr | Perspectives on preparing for long-acting injectable treatment for HIV among consumer, clinical and nonclinical stakeholders: A qualitative study exploring the anticipated challenges and opportunities for implementation in Los Angeles County. |
| title_full_unstemmed | Perspectives on preparing for long-acting injectable treatment for HIV among consumer, clinical and nonclinical stakeholders: A qualitative study exploring the anticipated challenges and opportunities for implementation in Los Angeles County. |
| title_short | Perspectives on preparing for long-acting injectable treatment for HIV among consumer, clinical and nonclinical stakeholders: A qualitative study exploring the anticipated challenges and opportunities for implementation in Los Angeles County. |
| title_sort | perspectives on preparing for long acting injectable treatment for hiv among consumer clinical and nonclinical stakeholders a qualitative study exploring the anticipated challenges and opportunities for implementation in los angeles county |
| url | https://doi.org/10.1371/journal.pone.0262926 |
| work_keys_str_mv | AT oluwadamilolajolayemi perspectivesonpreparingforlongactinginjectabletreatmentforhivamongconsumerclinicalandnonclinicalstakeholdersaqualitativestudyexploringtheanticipatedchallengesandopportunitiesforimplementationinlosangelescounty AT laurambogart perspectivesonpreparingforlongactinginjectabletreatmentforhivamongconsumerclinicalandnonclinicalstakeholdersaqualitativestudyexploringtheanticipatedchallengesandopportunitiesforimplementationinlosangelescounty AT erikdstorholm perspectivesonpreparingforlongactinginjectabletreatmentforhivamongconsumerclinicalandnonclinicalstakeholdersaqualitativestudyexploringtheanticipatedchallengesandopportunitiesforimplementationinlosangelescounty AT davidgoodmanmeza perspectivesonpreparingforlongactinginjectabletreatmentforhivamongconsumerclinicalandnonclinicalstakeholdersaqualitativestudyexploringtheanticipatedchallengesandopportunitiesforimplementationinlosangelescounty AT elenarosenbergcarlson perspectivesonpreparingforlongactinginjectabletreatmentforhivamongconsumerclinicalandnonclinicalstakeholdersaqualitativestudyexploringtheanticipatedchallengesandopportunitiesforimplementationinlosangelescounty AT rebeccacohen perspectivesonpreparingforlongactinginjectabletreatmentforhivamongconsumerclinicalandnonclinicalstakeholdersaqualitativestudyexploringtheanticipatedchallengesandopportunitiesforimplementationinlosangelescounty AT uyenkao perspectivesonpreparingforlongactinginjectabletreatmentforhivamongconsumerclinicalandnonclinicalstakeholdersaqualitativestudyexploringtheanticipatedchallengesandopportunitiesforimplementationinlosangelescounty AT steveshoptaw perspectivesonpreparingforlongactinginjectabletreatmentforhivamongconsumerclinicalandnonclinicalstakeholdersaqualitativestudyexploringtheanticipatedchallengesandopportunitiesforimplementationinlosangelescounty AT raphaeljlandovitz perspectivesonpreparingforlongactinginjectabletreatmentforhivamongconsumerclinicalandnonclinicalstakeholdersaqualitativestudyexploringtheanticipatedchallengesandopportunitiesforimplementationinlosangelescounty |