Reproductive-aged women with HIV express interest in long-acting ART options

Most reproductive-aged women with HIV infection are interested in using long-acting injectable antiretroviral therapy (ART) and prefer it over daily oral ART, according to survey results published in Clinical Infectious Diseases.

Researchers conducted a study among reproductive aged-women with HIV infection to determine their interest in using long-acting injectable ART. Study patients (N=103) were aged 18 to 45 years and enrolled from the Southern United States. The study was performed following the approval of cabotegravir (CAB) and rilpivirine (RPV) for long-acting ART. Between December 2022 and October 2023, the patients were surveyed about their willingness to try long-acting ART, their preference for it over oral ART, and whether they had any reproductive health concerns regarding its use.

Among women included in the final analysis, the median age was 35.9 years, 80.6% identified as Black, and the majority (79.4%) indicated multiple prior pregnancies (median, 3). At baseline, 80.2% of the population reported high rates of adherence (≥95%) to their current ART regimen.

When asked about the likelihood of trying long-acting ART for HIV management, survey responses among the population were as follows:

• Definite interest (41%);
• Probable interest (24%);
• Definite lack of interest (21%);
• Probable lack of interest (5%); and
• Unsure (9%).

In regard to the use of long-acting CAB/RPV-based ART every 2 months over daily oral ART for HIV management, 63.1% of patients preferred long-acting ART, 22.3% preferred daily ART, 7.8% were unsure, 5.8% indicated no preference, and 1 patient indicated they would not take HIV treatment regardless of the formulation.

Further analysis showed that the majority (63.1%) of patients surveyed reported no concerns regarding the potential impact of long-acting ART on pregnancy. The majority of patients also indicated no concerns in regard to safety issues for themselves or their future offspring (53.4%), breastfeeding (62.1%), the use of contraceptives (63.1%), spontaneous or induced abortions (68.9%), or future fertility (52.4%).

According to the researchers, “These findings underscore the urgent need for clinical data among WWH [women with HIV] across the reproductive lifespan on the safety and efficacy of long-acting ART, including LAI [long-acting injectable]-CAB/RPV, lenacapavir, and other agents in the pipeline.”

Disclosure: One study author reported affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

By Lisa Kuhns, PhD

References:

Collins LF, Sheth AN, Tisdale T, et al. Interest in and preference for long-acting injectable antiretroviral therapy in the era of approved cabotegravir/rilpivirine among reproductive-aged women in the U.S. South. Clin Infect Dis. Published online June 29, 2024. doi:10.1093/cid/ciae331