Do people with HIV really have the choice between oral and injectable ART? Evidence from a multicentric survey in the Swiss HIV cohort study
This study by Martin and colleagues assessed whether people living with HIV (PWH) are satisfied with their antiretroviral therapy, what they value about it and if they are aware newer injectable long-acting antiretroviral therapy (iLA-ART). While both oral and injectable ART treatment strategies have comparable efficacy, the authors argue that adequate information about their respective characteristics is essential to allow patients to make decisions aligned with their values and preferences.
The research team conducted a multicentric, paper-based survey at three HIV clinics affiliated with the Swiss HIV Cohort Study (SHCS) between November 2022 and January 2024. SHCS centres were selected to reflect the diversity of the Swiss HIV care landscape in terms of size, language region, and university versus non-university settings.
Using a questionnaire co-developed with expert patients (patient and public involvement, PPI), the study assessed four key dimensions: participants’ values and preferences regarding characteristics of modern oral ART and their treatment satisfaction; their knowledge about iLA-ART with cabotegravir/rilpivirine; the factors influencing their interest in switching, or not from oral to injectable long acting ART; and their perceived burden of treatment while taking oral ART.
200 people with HIV on oral ART were recruited. They had very high treatment satisfaction and perceived their burden of treatment as low. One of the main results of the study was that 39% of participants had never heard about iLA-ART, with important variations according to the SHCS center they were affiliated to (between 3% and 60% depending on the center). Furthermore, women were less likely thank men to have heard about iLA-ART, as well as older participants.
The authors conclude that the HIV care providers play a strong role in making people with HIV aware of newer treatment options. Treatment preferences are individual, but literacy regarding current ART strategies is essential to support informed treatment choices.