Abstract
BACKGROUND: HIV outcomes in people with HIV (PWH) are suboptimal and inequitably distributed in the United States. Long-acting injectable antiretroviral therapy (LAI-ART) has potential to make important contributions to improving HIV outcomes and quality of life for PWH. METHODS: The SELIGO Study used a 1-time, 20-minute survey of 801 PWH from the Center for AIDS Research Network of Integrated Clinical Systems cohort in 3 US cities (Boston, MA; Chapel Hill, NC; San Diego, CA) that included 54 items. Using multinomial and binary logistic regression, we assessed factors associated with LAI-ART versus daily oral ART preferences. RESULTS: Most participants were cisgender men (82.3%); 57.0% identified as racial and/or ethnic minorities; mean years of age, 52.2; mean years living with HIV, 18.1; 2.8% were using LAI-ART. Compared with daily oral ART, 56.9% preferred LAI-ART administered monthly, and 68.0% preferred LAI-ART administered every 2 months. Factors associated with greater odds of LAI-ART preference included medication/contraception injection experience, pill burden, no medication other than ART, 4 or more clinic visits per year, detectable viral load, reporting a higher number of HIV treatment considerations, and identifying as Black. Factors associated with decreased odds of LAI-ART preference included older age, identifying as neither gay nor straight, living > 1 hour from the clinic, and considerable/extreme needle fear. CONCLUSIONS: Findings demonstrate that although there is considerable interest in LAI-ART, HIV treatment modality preferences are multifaceted. Shared decision making can ensure that conversations about ART options consistently address specific factors across diverse groups to facilitate equitable LAI-ART uptake.