Mode of administration matters: Willingness of people with HIV to switch to future long-acting treatments, and health care professionals' intention to discuss these options

Introduction: Understanding preferences for long-acting regimens (LAR) of people with HIV and health care professionals (HCPs) is important to optimize and personalize care. We identified preferences for current and future LAR among people with HIV and investigated HCPs’ willingness to discuss these options. Methods: This study was conducted during routine clinic visits at Amsterdam UMC between September 2023 and March 2024. Six hypothetical descriptions of LAR represented through vignettes, illustrating administration mode, frequency, location, administrator and side effects, were presented to people with HIV. We asked if people with HIV were willing to consider a switch to each of these vignettes or preferred to continue their current oral regimen. We asked HCPs if they would be likely to discuss each of the vignettes as potential treatment options with people with HIV. Results: Of the 427 people with HIV [median age 56 (46–63) years; 79% males], 89% would be willing to switch to at least one and 10% to all options. The majority, namely, 76%, would consider switching to weekly tablets. Willingness to switch to intramuscular and subcutaneous injections, infusions and implants varied from 33% to 44%. HCPs (n = 23) indicated that they would discuss the different LAR options with 53% to 88% of people with HIV. All LAR options would be discussed in 32% of people with HIV. In 40%–43% of cases when people with HIV would be willing to switch to either intramuscular or intravenous regimes, the HCPs indicated that they would not discuss this treatment option. Conclusions: Most people with HIV would be willing to switch to weekly oral tablets. For the other LAR, lower levels of willingness were observed. Our findings suggest that HCPs may underestimate the willingness to switch to intramuscular injections and intravenous infusions in people with HIV.