"A dream come true": Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
16
03
2020
accepted:
30
05
2020
entrez:
13
6
2020
pubmed:
13
6
2020
medline:
28
8
2020
Statut:
epublish
Résumé
Long-acting injectable antiretroviral therapy (LA ART) was found to be non-inferior to daily oral ART in Phase 3 clinical trials. LA ART may offer an important alternative for people living with HIV with challenges adhering to daily oral ART or preferences for non-pill-based regimens. Using a mixed methods approach integrating survey, in-depth interview and biological data from female sex workers (FSW) living with HIV in Tanzania (N = 208) and the Dominican Republic (DR) (N = 201), we assessed factors associated with the potential likelihood of LA ART use if it were available. We conducted multivariate logistic regression and thematic content analysis. Likelihood of LA ART use was high with 84.92% of FSW from the DR and 92.27% of FSW from Tanzania reporting they would be "likely" or "very likely" to use LA ART if available (p = 0.02). In Tanzania better HIV-related patient-provider communication (AOR 4.58; 95% CI 1.90-11.05) and quality of HIV clinical care (AOR 3.68; 95% CI 1.05-12.86) were positively associated with the high likelihood of LA ART use. In the DR, easier clinic access was associated with a higher likelihood of LA ART use (AOR 3.04; 95% CI 1.41-6.56), as was greater monthly income from sex work (AOR 2.37; 95% CI 1.27-4.41). In both settings, years on ART was significantly associated with a strong likelihood of LA ART use (TZ: AOR 1.16 per year; 95% CI 1.00-1.34/DR: AOR 1.07 per year; 95% CI 1.00-1.14). Qualitative findings underscored enthusiasm for LA ART and reinforced its potential to address sex work-specific barriers to daily oral ART adherence including work-related schedules and substance use. We found a high likelihood of LA ART use if available among FSW in two diverse settings and documented barriers to future uptake. Community-driven approaches which include tailored health education and improved patient-provider communication and quality of care, as well as strategies to facilitate appointment adherence are needed to optimize LA ART use among FSW.
Sections du résumé
BACKGROUND
Long-acting injectable antiretroviral therapy (LA ART) was found to be non-inferior to daily oral ART in Phase 3 clinical trials. LA ART may offer an important alternative for people living with HIV with challenges adhering to daily oral ART or preferences for non-pill-based regimens.
METHODS
Using a mixed methods approach integrating survey, in-depth interview and biological data from female sex workers (FSW) living with HIV in Tanzania (N = 208) and the Dominican Republic (DR) (N = 201), we assessed factors associated with the potential likelihood of LA ART use if it were available. We conducted multivariate logistic regression and thematic content analysis.
RESULTS
Likelihood of LA ART use was high with 84.92% of FSW from the DR and 92.27% of FSW from Tanzania reporting they would be "likely" or "very likely" to use LA ART if available (p = 0.02). In Tanzania better HIV-related patient-provider communication (AOR 4.58; 95% CI 1.90-11.05) and quality of HIV clinical care (AOR 3.68; 95% CI 1.05-12.86) were positively associated with the high likelihood of LA ART use. In the DR, easier clinic access was associated with a higher likelihood of LA ART use (AOR 3.04; 95% CI 1.41-6.56), as was greater monthly income from sex work (AOR 2.37; 95% CI 1.27-4.41). In both settings, years on ART was significantly associated with a strong likelihood of LA ART use (TZ: AOR 1.16 per year; 95% CI 1.00-1.34/DR: AOR 1.07 per year; 95% CI 1.00-1.14). Qualitative findings underscored enthusiasm for LA ART and reinforced its potential to address sex work-specific barriers to daily oral ART adherence including work-related schedules and substance use.
CONCLUSIONS
We found a high likelihood of LA ART use if available among FSW in two diverse settings and documented barriers to future uptake. Community-driven approaches which include tailored health education and improved patient-provider communication and quality of care, as well as strategies to facilitate appointment adherence are needed to optimize LA ART use among FSW.
Identifiants
pubmed: 32530939
doi: 10.1371/journal.pone.0234666
pii: PONE-D-20-07582
pmc: PMC7292359
doi:
Substances chimiques
Anti-Retroviral Agents
0
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0234666Subventions
Organisme : NIMH NIH HHS
ID : K01 MH114715
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD050924
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI094189
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH110158
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Acquir Immune Defic Syndr. 2017 Jan 1;74 Suppl 1:S60-S68
pubmed: 27930613
J Acquir Immune Defic Syndr. 2009 May 1;51 Suppl 1:S52-9
pubmed: 19384103
AIDS Behav. 2010 Aug;14(4):778-84
pubmed: 19283464
PLoS One. 2016 Jan 25;11(1):e0147662
pubmed: 26808043
Curr Opin HIV AIDS. 2013 Nov;8(6):565-71
pubmed: 24100877
N Engl J Med. 2011 Aug 11;365(6):493-505
pubmed: 21767103
AIDS Care. 2020 May 14;:1-9
pubmed: 32408771
Res Nurs Health. 2001 Dec;24(6):518-29
pubmed: 11746080
PLoS One. 2018 Jan 5;13(1):e0190487
pubmed: 29304154
PLoS One. 2014 Sep 29;9(9):e105645
pubmed: 25265158
J Acquir Immune Defic Syndr. 2005 Nov 1;40(3):301-6
pubmed: 16249704
PLoS One. 2014 Feb 14;9(2):e88157
pubmed: 24551079
J Urban Health. 2014 Aug;91(4):736-51
pubmed: 25055750
AIDS Patient Care STDS. 2009 Nov;23(11):973-80
pubmed: 19821725
BMC Public Health. 2013 Jul 31;13:698
pubmed: 23898942
Curr HIV/AIDS Rep. 2009 Nov;6(4):224-31
pubmed: 19849966
Am Psychol. 2016 Nov;71(8):742-751
pubmed: 27977256
Lancet. 2017 Sep 23;390(10101):1499-1510
pubmed: 28750935
Curr Opin HIV AIDS. 2015 Jul;10(4):258-63
pubmed: 26049951
Schizophr Res Treatment. 2012;2012:407171
pubmed: 22966436
Curr Opin HIV AIDS. 2015 Jul;10(4):282-9
pubmed: 26049955
BMC Public Health. 2016 Jul 20;16:608
pubmed: 27440108
Curr HIV/AIDS Rep. 2020 Apr;17(2):88-96
pubmed: 32072467
Image J Nurs Sch. 1991 Fall;23(3):161-6
pubmed: 1916857
PLoS One. 2019 Nov 19;14(11):e0219032
pubmed: 31743336
J Acquir Immune Defic Syndr. 2016 Sep 1;73(1):83-90
pubmed: 27513573
AIDS Behav. 2014 Oct;18 Suppl 5:S505-15
pubmed: 23842717
HIV AIDS (Auckl). 2019 Jul 31;11:179-192
pubmed: 31447590
Infect Dis Ther. 2018 Jun;7(2):183-195
pubmed: 29761330
HIV Res Clin Pract. 2019 Aug - Oct;20(4-5):111-122
pubmed: 31533539
AIDS Care. 2012;24(7):846-55
pubmed: 22272891
Sex Transm Infect. 2010 Jun;86(3):236-40
pubmed: 20444745
AIDS Patient Care STDS. 2020 Feb;34(2):59-71
pubmed: 32049555
AIDS Behav. 2015 Aug;19(8):1510-26
pubmed: 25096896
New Microbiol. 2017 Apr;40(2):75-79
pubmed: 28368071
AIDS Patient Care STDS. 2006 Sep;20(9):637-48
pubmed: 16987050
AIDS Patient Care STDS. 2019 Mar;33(3):104-111
pubmed: 30844308
Afr J AIDS Res. 2016 Dec;15(4):377-386
pubmed: 27974017
AIDS Behav. 2020 Apr;24(4):1226-1236
pubmed: 31655915
BMC Infect Dis. 2019 Mar 5;19(1):210
pubmed: 30832613
AIDS Patient Care STDS. 2014 Sep;28(9):483-8
pubmed: 25093247
AIDS Behav. 2020 May 14;:
pubmed: 32410051
Clin Infect Dis. 2011 Mar 15;52(6):793-800
pubmed: 21367734
Expert Rev Anti Infect Ther. 2014 Oct;12(10):1203-19
pubmed: 25174997
Nanomedicine (Lond). 2013 Nov;8(11):1807-13
pubmed: 23611617
Curr Opin HIV AIDS. 2015 Jul;10(4):246-52
pubmed: 26049949
Am J Public Health. 2007 Jun;97(6):986-96
pubmed: 17463368