South African Parents' and Grandparents' Perspectives on the Acceptability of Implant Delivery of Treatment to Young Children with HIV.

Caregivers HIV treatment Implants Pediatric populations Qualitative end-user research

Journal

AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133

Informations de publication

Date de publication:
28 Oct 2024
Historique:
accepted: 16 09 2024
medline: 28 10 2024
pubmed: 28 10 2024
entrez: 28 10 2024
Statut: aheadofprint

Résumé

Children living with HIV (CLWH) face unique challenges with adherence to antiretroviral therapy. In South Africa, just over a third of children receiving antiretroviral therapy are virally suppressed. Long-acting, subcutaneous implants may improve outcomes in CLWH compared to current daily oral dosing regimens. Qualitative in-depth interviews and focus group discussions (FGD) were conducted with 50 caregivers of CLHW in Johannesburg, South Africa. Interviews and FGDs were audio-recorded and transcribed. Data were coded and analyzed using Dedoose v9 software and a thematic approach. Caregivers had generally positive impressions of the pediatric HIV treatment implant. They emphasized the advantages of a long-acting and discreet treatment option for CLWH. Cited advantages were perceived to have widespread impact on CLWH, their caregivers, and other social dynamics. Caregivers raised some concerns or uncertainties about the potential efficacy, side effects and safety of the implant. Future clinical testing and outreach efforts may address such concerns and mitigate potential misinformation about implants. This study indicates the need to develop long-acting, discreet, safe, and efficacious HIV treatment options for young children.

Identifiants

pubmed: 39465464
doi: 10.1007/s10461-024-04515-8
pii: 10.1007/s10461-024-04515-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

UNAIDS. 2023 estimates. Global HIV & AIDS statistics - fact sheet 2023.
HIV/AIDS JUNPo. UNAIDS Data 2023. Switzerland: Geneva; 2023.
Saitoh A, Foca M, Viani RM, et al. Clinical outcomes after an unstructured treatment interruption in children and adolescents with perinatally acquired HIV infection. Pediatr Mar. 2008;121(3):e513–521.
doi: 10.1542/peds.2007-1086
Schlatter AF, Deathe AR, Vreeman RC. The need for Pediatric formulations to treat children with HIV. AIDS Res Treat. 2016;2016:1654938.
pubmed: 27413548 pmcid: 4927993
Nemathaga L, Mafune R, Lebese R. Challenges faced by caregivers of children on antiretroviral therapy at Mutale Municipality selected healthcare facilities, Vhembe District, Limpopo Province. Curationis. 2017;40(1):1–9.
(NIAID) NIoAaID. HIV Treatment in Infants and Children. 2019; https://www.niaid.nih.gov/diseases-conditions/hiv-treatment-children
Study of Oral and Long-Acting Injectable Cabotegravir. And Rilpivirine in Virologically Suppressed Children Living with HIV-1, Two to Less Than 12 Years of Age. 2022; https://classic.clinicaltrials.gov/show/NCT05660980
Moffatt K, Tekko IA, Vora L, et al. Development and evaluation of dissolving microarray patches for co-administered and repeated intradermal delivery of long-acting Rilpivirine and Cabotegravir Nanosuspensions for Paediatric HIV antiretroviral therapy. Pharm Res Jul. 2023;40(7):1673–96.
Abrams EJ, Capparelli E, Ruel T, Mirochnick M. Potential of long-acting products to transform the Treatment and Prevention of Human Immunodeficiency Virus (HIV) in infants, children, and adolescents. Clin Infect Dis. 2022;75(Supplement4):S562–70.
doi: 10.1093/cid/ciac754 pubmed: 36410381 pmcid: 10200315
Lochmiller CR. Conducting Thematic Analysis with Qualitative Data. The Qualitative Report. 2021.
Hawley I, Scorgie F, Pahad S et al. Healthcare providers’ views on the acceptability of implants for HIV treatment in young children in Johannesburg, South Africa. Paper presented at: International Association of Providers of AIDS Care Adherence 20212021; Orlando, FL, United States.
Scorgie F, Hawley I, Fairlie L, et al. Acceptability of implants for HIV Treatment in Young children: perspectives of Health Care providers in Johannesburg, South Africa. AIDS Patient care STDs Oct. 2022;36(10):389–95.
doi: 10.1089/apc.2022.0087
Krogstad EA, Atujuna M, Montgomery ET, et al. Perspectives of South African youth in the development of an implant for HIV prevention. J Int AIDS Soc. 2018;21(8):e25170.
doi: 10.1002/jia2.25170 pubmed: 30152004 pmcid: 6111144
Krogstad EA, Montgomery ET, Atujuna M, et al. Design of an Implant for Long-Acting HIV Pre-exposure Prophylaxis: Input from South African Health Care Providers. AIDS Patient care STDs Apr. 2019;33(4):157–66.
doi: 10.1089/apc.2018.0177
Brown MS, Hanif H, Little KM, et al. End-user research in support of long-acting systemic antiretroviral delivery systems: insights from qualitative research with providers and target users in South Africa. BMC Infect Dis. 2022;2022/12/08(1):919.
doi: 10.1186/s12879-022-07907-0
Browne E, Manenzhe K, Makoni W et al. Incorporating End-Users’ Voices into the Development of an Implant for HIV Prevention: A Discrete Choice Experiment in South Africa and Zimbabwe2022.
Schieffer RJ, Bryndza Tfaily E, D’Aquila R, et al. Conjoint Analysis of user acceptability of sustained long-acting Pre-exposure Prophylaxis for HIV. AIDS Res Hum Retroviruses Apr. 2022;38(4):336–45.
doi: 10.1089/aid.2021.0075
Nkomo S, Makoni W, Shapley-Quinn MK, et al. Prospective acceptability of a multipurpose technology (MPT) implant in preclinical development to prevent HIV and unplanned pregnancy: qualitative insights from women end users and health care providers in South Africa and Zimbabwe. PLoS ONE. 2023;18(5):e0285711.
doi: 10.1371/journal.pone.0285711 pubmed: 37195918 pmcid: 10191314
Montgomery ET, Hawley I, Fairlie L et al. Acceptability of the Dapivirine Vaginal Ring and oral Truvada among African users in late-stage of pregnancy. AIDS Behav 2024;28(3):963–973. https://doi.org/10.1007/s10461-023-04203-z .
Stoner MCD, Hawley I, Mathebula F et al. Acceptability and Use of the Dapivirine Vaginal Ring and Daily Oral Pre-exposure Prophylaxis (PrEP) During Breastfeeding in South Africa, Malawi, Zimbabwe, and Uganda. AIDS and Behavior. 2023/12/01 2023;27(12):4114–4123.

Auteurs

Imogen Hawley (I)

Women's Global Health Imperative, RTI International, Berkeley, CA, USA.

Alejandro Baez (A)

Women's Global Health Imperative, RTI International, Berkeley, CA, USA.

Fiona Scorgie (F)

Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Lee Fairlie (L)

Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. lfairlie@wrhi.ac.za.

Florence Mathebula (F)

Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Mackenzie Leigh Cottrell (ML)

UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA.

Leah M Johnson (LM)

RTI International, Research Triangle Park, NC, USA.

Elizabeth T Montgomery (ET)

Women's Global Health Imperative, RTI International, Berkeley, CA, USA.
Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.

Classifications MeSH