Key informant views on potential acceptability and feasibility of long-acting antiretroviral treatment for HIV in Kenya
Abstract Background In 2020, 14% of diagnosed persons living with HIV (PLWH) in Kenya were not taking antiretroviral therapy (ART), and 19% of those on ART had unsuppressed viral loads. Long-acting antiretroviral therapy (LA-ART) may increase viral suppression by promoting ART uptake and adherence....
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-024-09309-w |
| _version_ | 1797199589227364352 |
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| author | Anne Kaggiah Catherine N. Maina John Kinuthia Douglas Barthold Brett Hauber Jacinda Tran Jane M. Simoni Susan M. Graham |
| author_facet | Anne Kaggiah Catherine N. Maina John Kinuthia Douglas Barthold Brett Hauber Jacinda Tran Jane M. Simoni Susan M. Graham |
| author_sort | Anne Kaggiah |
| collection | DOAJ |
| description | Abstract Background In 2020, 14% of diagnosed persons living with HIV (PLWH) in Kenya were not taking antiretroviral therapy (ART), and 19% of those on ART had unsuppressed viral loads. Long-acting antiretroviral therapy (LA-ART) may increase viral suppression by promoting ART uptake and adherence. We conducted key informant (KI) interviews with HIV experts in Kenya to identify product and delivery attributes related to the acceptability and feasibility of providing LA-ART to PLWH in Kenya. Methods Interviews were conducted via Zoom on potential LA-ART options including intra-muscular (IM) injections, subcutaneous (SC) injections, implants, and LA oral pills. KI were asked to discuss the products they were most and least excited about, as well as barriers and facilitators to LA-ART roll-out. In addition, they were asked about potential delivery locations for LA-ART products such as homes, pharmacies, and clinics. Interviews were recorded and transcribed, and data were analyzed using a combination of inductive and deductive coding. Results Twelve KI (5 women, 7 men) participated between December 2021 and February 2022. Overall, participants reported that LA-ART would be acceptable and preferable to PLWH because of fatigue with daily oral pills. They viewed IM injections and LA oral pills as the most exciting options to ease pill burden and improve adherence. KI felt that populations who could benefit most were adolescents in boarding schools and stigmatized populations such as sex workers. SC injections and implants were less favored, as they would require new training initiatives for patients or healthcare workers on administration. In addition, SC injections would require refrigeration and needle disposal after use. Some KI thought patients, especially men, might worry that IM injections and implants would impact fertility, given their role in family planning. Pharmacies were perceived by most KI as suboptimal delivery locations; however, given ongoing work in Kenya to include pharmacies in antiretroviral delivery, they recommended asking patients their views. Conclusion There is interest and support for LA-ART in Kenya, especially IM injections and LA oral pills. Identifying patient preferences for modes and delivery locations and addressing misconceptions about specific products as they become available will be important before wide-scale implementation. |
| first_indexed | 2024-04-24T07:18:09Z |
| format | Article |
| id | doaj.art-1232d9faad2b48a6973b3060a2b283ff |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-24T07:18:09Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-1232d9faad2b48a6973b3060a2b283ff2024-04-21T11:10:24ZengBMCBMC Infectious Diseases1471-23342024-04-0124111210.1186/s12879-024-09309-wKey informant views on potential acceptability and feasibility of long-acting antiretroviral treatment for HIV in KenyaAnne Kaggiah0Catherine N. Maina1John Kinuthia2Douglas Barthold3Brett Hauber4Jacinda Tran5Jane M. Simoni6Susan M. Graham7Research and Programs Department, Kenyatta National HospitalResearch and Programs Department, Kenyatta National HospitalResearch and Programs Department, Kenyatta National HospitalThe Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of WashingtonThe Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of WashingtonThe Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of WashingtonOffice of Behavioral and Social Sciences ResearchDepartment of Global Health, University of WashingtonAbstract Background In 2020, 14% of diagnosed persons living with HIV (PLWH) in Kenya were not taking antiretroviral therapy (ART), and 19% of those on ART had unsuppressed viral loads. Long-acting antiretroviral therapy (LA-ART) may increase viral suppression by promoting ART uptake and adherence. We conducted key informant (KI) interviews with HIV experts in Kenya to identify product and delivery attributes related to the acceptability and feasibility of providing LA-ART to PLWH in Kenya. Methods Interviews were conducted via Zoom on potential LA-ART options including intra-muscular (IM) injections, subcutaneous (SC) injections, implants, and LA oral pills. KI were asked to discuss the products they were most and least excited about, as well as barriers and facilitators to LA-ART roll-out. In addition, they were asked about potential delivery locations for LA-ART products such as homes, pharmacies, and clinics. Interviews were recorded and transcribed, and data were analyzed using a combination of inductive and deductive coding. Results Twelve KI (5 women, 7 men) participated between December 2021 and February 2022. Overall, participants reported that LA-ART would be acceptable and preferable to PLWH because of fatigue with daily oral pills. They viewed IM injections and LA oral pills as the most exciting options to ease pill burden and improve adherence. KI felt that populations who could benefit most were adolescents in boarding schools and stigmatized populations such as sex workers. SC injections and implants were less favored, as they would require new training initiatives for patients or healthcare workers on administration. In addition, SC injections would require refrigeration and needle disposal after use. Some KI thought patients, especially men, might worry that IM injections and implants would impact fertility, given their role in family planning. Pharmacies were perceived by most KI as suboptimal delivery locations; however, given ongoing work in Kenya to include pharmacies in antiretroviral delivery, they recommended asking patients their views. Conclusion There is interest and support for LA-ART in Kenya, especially IM injections and LA oral pills. Identifying patient preferences for modes and delivery locations and addressing misconceptions about specific products as they become available will be important before wide-scale implementation.https://doi.org/10.1186/s12879-024-09309-wHIVLong-acting antiretroviralAcceptabilityFeasibilityKenya |
| spellingShingle | Anne Kaggiah Catherine N. Maina John Kinuthia Douglas Barthold Brett Hauber Jacinda Tran Jane M. Simoni Susan M. Graham Key informant views on potential acceptability and feasibility of long-acting antiretroviral treatment for HIV in Kenya BMC Infectious Diseases HIV Long-acting antiretroviral Acceptability Feasibility Kenya |
| title | Key informant views on potential acceptability and feasibility of long-acting antiretroviral treatment for HIV in Kenya |
| title_full | Key informant views on potential acceptability and feasibility of long-acting antiretroviral treatment for HIV in Kenya |
| title_fullStr | Key informant views on potential acceptability and feasibility of long-acting antiretroviral treatment for HIV in Kenya |
| title_full_unstemmed | Key informant views on potential acceptability and feasibility of long-acting antiretroviral treatment for HIV in Kenya |
| title_short | Key informant views on potential acceptability and feasibility of long-acting antiretroviral treatment for HIV in Kenya |
| title_sort | key informant views on potential acceptability and feasibility of long acting antiretroviral treatment for hiv in kenya |
| topic | HIV Long-acting antiretroviral Acceptability Feasibility Kenya |
| url | https://doi.org/10.1186/s12879-024-09309-w |
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