OBJECTIVES: People living with HIV (PLWH) need to adhere to antiretroviral therapies (ART) to achieve and maintain viral suppression. Novel long-acting ART (LA-ART) regimens may improve adherence and thereby increase effectiveness. This study aimed to pilot test an adapted discrete choice experiment (DCE) eliciting patient preferences for LA-ART among PLWH in Kenya.

METHODS: Participants were recruited from the Kenyatta National Hospital HIV clinic, underwent a survey about sociodemographic and HIV-related characteristics, and were asked for consent to link responses to their clinical data. In the DCE, participants chose between two hypothetical LA-ART regimens and their current regimen in 17 scenarios. Conditional logistic regressions examined the relationship between choices and seven LA-ART attributes: delivery mode, location, frequency, pain, pre-treatment viral suppression, pre-treatment testing for negative reactions, and late-dose leeway. Regression used interactions between delivery mode (oral, injection, implant) and level of pain (none, mild, moderate).

RESULTS: Fifty participants completed the pilot DCE (median age 36.0 years [interquartile range: 28.5 – 45], 44% female, 68% undetectable viral load, and 6% ART naïve). Overall, participants preferred the hypothetical LA-ART alternatives over their current therapies. Mode of delivery interacted with pain was the most important attribute: oral LA-ART with no pain was the most preferred, followed by injection with mild pain. Participants favored receiving treatment at clinics, less frequent dosing, and longer leeway periods after a late dose.

CONCLUSIONS: Participants in this pilot study preferred oral LA-ART and generally chose hypothetical LA-ART regimens over their current daily oral therapies. Key attributes of preferred LA-ART were delivery at clinics, less frequent dosing, and longer leeway periods after a late dose. A full-scale DCE with 700 participants in Kenya will be conducted to further investigate patient preferences related to LA-ART.