Factors Associated with Preferences for Long-Acting Injectable Antiretroviral Therapy Among Adolescents and Young People Living with HIV in South Africa

被引:13
|
作者
Toska, Elona [1 ,2 ,3 ]
Zhou, Siyanai [1 ,4 ]
Chen-Charles, Jenny [3 ]
Gittings, Lesley [1 ,5 ]
Operario, Don [6 ]
Cluver, Lucie [3 ,7 ]
机构
[1] Univ Cape Town, Ctr Social Sci Res, 4-89 Rondebosch, ZA-7700 Cape Town, South Africa
[2] Univ Cape Town, Dept Sociol, Cape Town, South Africa
[3] Univ Oxford, Dept Social Policy & Intervent, Oxford, England
[4] Univ Cape Town, Sch Publ Hlth & Family Med, Cape Town, South Africa
[5] Western Univ, Fac Hlth Sci, Sch Hlth Studies, London, ON, Canada
[6] Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA
[7] Univ Cape Town, Dept Child & Adolescent Psychiat, Cape Town, South Africa
基金
美国国家卫生研究院;
关键词
Adolescents; Antiretroviral; Long-acting; Injectables; South Africa; ADHERENCE; CABOTEGRAVIR; PREVENTION; OUTCOMES; ADULTS; YOUTH; RILPIVIRINE; RETENTION; AGENTS; SCALE;
D O I
10.1007/s10461-022-03949-2
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Long-acting injectable anti-retroviral therapy (LAART) may overcome barriers to long-term adherence and improve the survival of adolescents and young people living with HIV (AYLHIV). Research on the acceptability of LAART for this age-group is limited. We asked 953 AYLHIV about their preferred (theoretical) ART mode of delivery (pill, injectable, or other) in 2017-2018, before LAART was available or known to AYLHIV in South Africa. One in eight (12%) AYLHIV preferred LAART over single or multiple pill regimens. In multivariate analyses, six factors were associated with LAART preference: medication stock-outs (aOR = 2.56, 95% CI 1.40-4.68, p = 0.002), experiencing side-effects (aOR = 1.84, 95% CI 1.15-2.97, p = 0.012), pill-burden (aOR = 1.88, 95% CI 1.20-2.94, p = 0.006), past-year treatment changes (aOR = 1.63, 95% CI 1.06-2.51, p = 0.025), any HIV stigma (aOR = 2.22, 95% CI 1.39-3.53, p <= 0.001) and recent ART initiation (aOR = 2.02, 95% CI 1.09-3.74, p = 0.025). In marginal effects modelling, 66% of adolescents who experienced all factors were likely to prefer LAART, highlighting the potential high acceptability of LAART among adolescents and young people living with HIV struggling to adhere and have good HIV treatment outcomes. Adolescent boys who reported high ART pill burden were more likely to prefer LAART than their female peers in moderation analyses, suggesting that LAART may be particularly important to improve treatment outcomes among male AYLHIV as they become older. Adding LAART to existing treatment options for AYLHIV, particularly higher risk groups, would support AYLHIV to attain and sustain viral suppression-the third 95, and reduce their risk of AIDS-related mortality.
引用
收藏
页码:2163 / 2175
页数:13
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