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. 2019 Feb 1;80(2):190-197.
doi: 10.1097/QAI.0000000000001896.

Interest of Youth Living With HIV in Long-Acting Antiretrovirals

Ethel D Weld  1 , Md Sohel Rana  2 , Ronald H Dallas  3 , Andres F Camacho-Gonzalez  4   5 , Patrick Ryscavage  6 , Aditya H Gaur  3 , Rana Chakraborty  4   5 , Susan Swindells  7 , Charles Flexner  1 , Allison L Agwu  8
Affiliations

Interest of Youth Living With HIV in Long-Acting Antiretrovirals

Ethel D Weld et al. J Acquir Immune Defic Syndr. .

Abstract

Objectives: This study's primary objective was to characterize attitudes to long-acting antiretrovirals (LAARV), among youth aged 13-24 years living with perinatally acquired HIV and nonperinatally acquired HIV. Secondary objectives included: assessing whether those with detectable HIV RNA PCR viral load had higher enthusiasm for LAARV compared to those with suppressed viral load, and examining characteristics associated with LAARV enthusiasm.

Methods: A cross-sectional survey of 303 youth living with HIV (YHIV) followed at 4 pediatric/adolescent HIV clinics in the United States was performed to determine interest in LAARV, using a modified survey instrument previously used in adults. Interest in LAARV across groups was compared. Poisson regression with robust variance was used to determine the impact of various characteristics on interest in LAARV.

Findings: Overall, 88% of YHIV reported probable or definite willingness to use LAARV. The enthusiasm level was similar between youth with perinatally acquired HIV and nonperinatally acquired HIV (P = 0.93). Youth with HIV viral load >1000 copies per milliliter had significantly higher interest than youth with suppressed viral load [prevalence ratio 1.12 (95% confidence interval: 1.03 to 1.20); P = 0.005]. Female youth participants who had had past experience with implantable contraceptive methods had a significantly higher interest in LAARV (100% vs. 85.5%; P = 0.002). Proportion of respondents endorsing definite willingness to use was significantly higher with decreased injection frequency compared with increased injection frequency.

Interpretation: YHIV at 4 urban US pediatric/adolescent HIV clinics had high levels of enthusiasm for LAARV. LAARV should be given high priority as a potentially viable treatment option to improve clinical outcomes in YHIV.

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Figures

Figure 1:
Figure 1:. Adjusted Prevalence Ratio of High Interest in LAARV by Participant Characteristics.
Reference values for each category: Perinatal Acquisition; Viral Load Undetectable; Clinic: Emory; Age category: 13–16 years old; Gender: Male; Never Used EtOH; Never Used Marijuana. Interest in LAARV defined as “Probably would use” or “Definitely would use”, as compared to “Definitely would not use” or “Probably would not use”.
Figure 2a:
Figure 2a:
Gradient of Definite or Probable Willingness to Use Increases with Decreased Injection Frequency
Figure 2b:
Figure 2b:. Proportion of Definite Willingness to Use Is Higher with Decreased Injection Frequency Compared to Increased Injection Frequency
Z-scores are displayed in table for a two sample proportion test (p values in parentheses). Significant values are in bold. The injection frequencies specified in the column headings are what is being compared to row headings (the reference).
Figure 3:
Figure 3:. Comparison of Interest in LAARV by Various Characteristics
*p<0.05; significance tested by adjusted Poisson regression, robust variance. In Figure a), Viral loads were one-time, cross-sectional viral load results most proximal in time to the survey. Undetectable HIV viral load was defined as <20 copies or <40 copies, depending on site; Low detectable as >UD and <1000; High detectable > 1000 copies. For Figures b) and c), a binary interest level outcome was used, where Interested was “Probably would or Definitely would use” and Not Interested was “Definitely would not use” or “probably would not use”.
Figure 4:
Figure 4:. Youth Preference for intramuscular (IM) over subdermal (SD) Implantable LAARV
* t-test for proportions: p= 0.002
See this image and copyright information in PMC

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