Interest of Youth Living With HIV in Long-Acting Antiretrovirals

• Type of Material: Article
• Authors: Ethel D. Weld, Johns Hopkins University; Md-Sohel Rana, Johns Hopkins University; Ronald H. Dallas, St Jude Children's Research Hospital; Andres Camacho-Gonzalez, Emory University; Patrick Ryscavage, University of Maryland; Aditya H. Gaur, St Jude Children's Research Hospital; Rana Chakraborty, Emory University; Susan Swindells, University of Nebraska Medical Center; Charles Flexner, Johns Hopkins University; Allison L. Agwu, Johns Hopkins University
• Language: English
• Date: 2019-02-01
• Publisher: Lippincott, Williams &Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 Wolters Kluwer Health, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/QAI.0000000000001896
• Title of Journal or Parent Work: Journal of Acquired Immune Deficiency Syndromes
• ISSN: 1525-4135
• Volume: 80
• Issue: 2
• Start Page: 190
• End Page: 197
• Grant/Funding Information: The Johns Hopkins University Center for AIDS Research (CFAR) under award number P30AI094189: Adolescent and Young Adult Scientific Working Group microgrant; The National Institute of General Medical Sciences (NIGMS) of the National Institutes of Health (NIH) under T32 award numbers GM066691-GM066691–12; The Johns Hopkins Clinical Research Scholars Program (KL2); The National Institute of Allergy and Infectious Diseases (NIAID) of the NIH (R24 AI 118397); The Pearl M. Stetler Research Award for Women Physicians
• Keywords: Infectious Diseases; HIV; HIV care continuum; THERAPY; Science & Technology; patient acceptance of health care; long-acting antiretroviral agents; adolescent; ADHERENCE; MEN; treatment; Immunology; PREFERENCES; Life Sciences & Biomedicine; ADOLESCENTS; ADULTS
• Research Categories: Health Sciences, Public Health; Health Sciences, Medicine and Surgery

Abstract

Objectives:This study's primary objective was to characterize attitudes to long-acting antiretrovirals (LAARV), among youth aged 13-24 years living with perinatally acquired HIV and nonperinatally acquired HIV. Secondary objectives included: assessing whether those with detectable HIV RNA PCR viral load had higher enthusiasm for LAARV compared to those with suppressed viral load, and examining characteristics associated with LAARV enthusiasm. Methods:A cross-sectional survey of 303 youth living with HIV (YHIV) followed at 4 pediatric/adolescent HIV clinics in the United States was performed to determine interest in LAARV, using a modified survey instrument previously used in adults. Interest in LAARV across groups was compared. Poisson regression with robust variance was used to determine the impact of various characteristics on interest in LAARV. Findings:Overall, 88% of YHIV reported probable or definite willingness to use LAARV. The enthusiasm level was similar between youth with perinatally acquired HIV and nonperinatally acquired HIV (P = 0.93). Youth with HIV viral load >1000 copies per milliliter had significantly higher interest than youth with suppressed viral load [prevalence ratio 1.12 (95% confidence interval: 1.03 to 1.20); P = 0.005]. Female youth participants who had had past experience with implantable contraceptive methods had a significantly higher interest in LAARV (100% vs. 85.5%; P = 0.002). Proportion of respondents endorsing definite willingness to use was significantly higher with decreased injection frequency compared with increased injection frequency. Interpretation:YHIV at 4 urban US pediatric/adolescent HIV clinics had high levels of enthusiasm for LAARV. LAARV should be given high priority as a potentially viable treatment option to improve clinical outcomes in YHIV.