US survey reports middling interest in long-acting injectable treatment among women with HIV

Fewer than half of cisgender women on oral antiretroviral therapy expressed an interest in trying injectable HIV treatment, a U.S. survey found.

About This Study

“Likelihood of trying long-acting injectable antiretroviral therapy (LAI ART) among women with HIV in nine sites across the United States” was published online on April 12, 2024, in Journal of Acquired Immune Deficiency Syndromes. The lead author is Tara McCrimmon, M.P.H., M.I.A., of the Department of Sociomedical Sciences at Columbia University Mailman School of Public Health in New York, New York.

Key Research Findings

Researchers surveyed 1,078 cisgender women living with HIV in nine U.S. urban areas during 2020-2021 about their interest in long-acting injectable HIV treatment. Currently, only cabotegravir/rilpivirine (Cabenuva) is approved in the U.S. for this purpose.

Mean participant age was 54 years, 73% of participants were Black, and 11% of participants reported substance use in the past year. Eighty-eight percent of participants said they had taken their HIV drugs ≥ 95% of the time, and 72% of participants had an undetectable viral load.

After receiving a standardized explanation, participants were asked about their interest in long-acting injectable antiretroviral therapy. Fewer than one-half of women thought they might try it (22% of participants responded “probably” and 20% of participants said “definitely” likely) while 36% of participants wouldn’t want it (24% of participants responded “definitely not,” and 12% said “probably not”). Twenty-one percent of participants were not sure about their interest in this treatment modality.

Interest was higher among women with recent substance use and lower among older women and those reporting high adherence, compared to their respective counterparts. Miami, Florida, had the lowest number of participants (62) and women there were less enthusiastic about injectable HIV drugs than those elsewhere.

Discussion Highlights and Implications for Practice

The researchers pointed out the limitation that expressing willingness to try a treatment modality does not necessarily translate into actually using it.

They also said that further research is needed into geographic differences, as well as reasons behind indecision about long-acting injectable HIV treatment. Given current guidelines, greater acceptance of injected medications among women with recent substance use may not translate into providers offering that option. The authors remarked, “… there is a need to ensure that women who want LAI ART are eligible to receive it and get the necessary support to ensure continued adherence.”

Additional barriers reported include the lack of information on this treatment modality during pregnancy, the need for more frequent clinic visits, and general mistrust of medical injections.

By Barbara Jungwirth