Abstract
INTRODUCTION: Long-acting antiretroviral (LAARV) regimens have been shown to be as effective as standard daily oral antiretroviral therapy (ART) in maintaining HIV-1 suppression. China has one of the largest populations of people living with HIV (PLHIV) and provides a national free ART program with limited regimens, which currently does not include LAARV. The acceptability of LAARV among PLHIV in China remains unknown. METHODS: Between 1 June 2022 and 30 November 2022, we conducted an online survey among PLHIV in China to assess their acceptance and preference for LAARV. Acceptance was measured on a five-point scale and dichotomized into "more likely to use" (including "definitely" and "probably") and "less likely to use" (including "uncertainly", "would not" and "definitely would not"). Logistic regression was used to identify factors associated with acceptance. RESULTS: Among the 2570 PLHIV who responded to the questionnaire, 67% expressed interest in LAARV. Participants currently using a single-tablet regimen (STR) showed the highest interest in LAARV (adjusted odds ratio [AOR] 1.64, 95% confidence interval [CI] 1.29-2.10). A subjective assessment of suboptimal ART adherence was also associated with greater interest (AOR 2.25, 95% CI 1.13-4.49). Preferences for LAARV modalities, in descending order, were intramuscular injection (every 1-2 months), subdermal implants (every 6-12 months), and intravenous infusion (every 1-2 weeks). CONCLUSIONS: This study reveals a high acceptance of LAARV among PLHIV in China and identifies key potential user groups, thereby addressing a critical evidence gap regarding LAARV implementation in the country. A cost-competitive long-acting intramuscular injection ART is the most preferred LAARV option in China.