| Summary: | Introduction
The worldview in relation to patient care
has shifted from conquering diseases to improving overall
wellbeing and quality of life. We examined treatment
aspirations among people living with HIV (PLHIV).
Methods
In all, 2389 PLHIV were surveyed in the
25-country 2019 Positive Perspectives Study. Descriptive
and multivariable analyses were used to explore attitudes
towards treatment.
Results
Participants were from: Northern America (USA,
Canada), 21.8% (520/2389); Europe, 46.8% (1119/2389);
and other international regions, 31.4% (750/2389). Factors
associated with some level of dissatisfaction with HIV
medication among those otherwise fully satisfied with their
HIV management included being on a multi-tablet regimen
(AOR=2.76; 95% CI: 1.93–3.96), reporting polypharmacy
(AOR=2.10; 95% CI: 1.45–3.03), and experiencing side effects
from current HIV medication (AOR=2.12; 95% CI: 1.49–3.02).
Of seven improvements to HIV medications assessed, the
percentage ranking each attribute, as the first or second
most important, was: ‘reduced long-term impact on my body’
(46.7%); ‘longer-lasting medicine so I don’t have to take it
every day’ (43.1%); ‘fewer side effects’ (40.5%); ‘less HIV
medicine each day but just as effective’ (25.4%); ‘less chance
of affecting other medicines’ (21.6%); ‘no food restrictions/
requirements’ (14.0%); and ‘smaller pills’ (8.7%). Overall,
77.1% (1842/2389) believed ‘future advances in HIV
treatment will improve my overall wellbeing’, 72.2%
(1726/2389) were ‘open to taking an HIV treatment
composed of fewer medicines’, while 54.7% (1306/2389)
expressed openness towards longer-acting (non-daily)
HIV medication. Compared to those not fully satisfied with
either their HIV medication or management, those fully
satisfied with both reported significantly higher prevalence
of optimal treatment adherence (89.2% [372/417] vs 69.5%
[763/1098]) and optimal overall health (70.3% [293/417] vs
47.8% [525/1098]) (all p<0.001).
Conclusions
Many PLHIV perceived gaps in their care and
aspired for novel treatments. Providing flexible treatment
options can help patients across the spectrum of unmet
needs and improve health-related quality of life.
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