Preferences of People Living With HIV-1 for HIV Treatment Regimen Attributes: A Qualitative Interview Study

OBJECTIVES: This qualitative interview study described overall preferences of people living with HIV-1 and healthcare providers (HCPs) regarding attributes associated with HIV-1 treatment, particularly long-acting injectable options, and factors influencing these preferences.

METHODS: Individual qualitative interviews with people living with HIV-1 and HCPs in the United States were conducted to assess overall preferences when considering a treatment switch for the following attributes related to HIV-1 treatment previously identified from a targeted literature review: mode of administration, treatment administration setting, treatment administration frequency, injection location on body, and side effects. Influencing factors and spontaneously mentioned attributes were also recorded.

RESULTS: Interviews were conducted with 50 people living with HIV-1 and 5 HCPs (physicians, n=3; nurse practitioner, n=1; physician assistant, n=1). The majority of people living with HIV-1 were male (60%), with no prior injectable experience (62%), and had a mean age of 48.6 (range: 23-70) years. Both groups ranked side effects as highest priority, followed by treatment administration frequency. Highest-ranked spontaneously mentioned attributes among people living with HIV-1 were cost and number of injections. Regarding side effects, people living with HIV-1 were most concerned about weight gain, diabetes, and adverse gastrointestinal effects. Most people living with HIV-1 preferred 4- and/or 6-month intervals for HCP-administered injections (96% and 95%, respectively), citing alignment with appointments and HCP relationships, and 3-month intervals for self-administered injections (94%), considering storage and disposal. Oral administration was preferred by 92% of people living with HIV-1.

CONCLUSIONS: People living with HIV-1 prioritize minimizing side effects and reducing injection frequency when making treatment decisions. A planned quantitative discrete choice experiment will assess generalizability of these findings in a larger sample with broader geographical reach and provide evidence of risk tolerance and perspectives on benefit regarding different HIV-1 treatment modalities for health technology assessment and regulatory bodies.