A Universal Approach to Educating Patients with HIV about Long-Acting Injectable Treatment for HIV.

Abstract

Long-acting injectable antiretroviral treatment (LAI ART) has the potential to transform HIV care and reduce HIV-related health inequities in achieving and maintaining viral suppression. However, without a plan for equitable roll-out of LAI ART, new pharmacological innovations in HIV treatment and prevention risk further deepening health disparities. This study delineates a process for providing universal LAI ART education to people with HIV (PWH) at an urban outpatient infectious disease clinic and documents the outcomes of these efforts. We compared the number and proportion of patients with HIV educated about injectable cabotegravir-rilpivirine (iCAB/RPV) and, among those educated, the number and proportion of patients interested in learning more about iCAB/RPV under a selective education model compared to a universal education model, disaggregated by race/ethnicity, sex, and age. We used a Chi-sq test to estimate p-values for the difference in proportions. The universal compared to selective education approach resulted in a larger proportion of clients educated and a greater proportion of people educated reporting interest in LAI ART. Slight differences observed between those never versus ever educated in the selective education were absent after the adoption of a universal education approach. Reasons for disinterest -- including fear of injections, not interested in more frequent clinic visits, and content with oral ART regimen -- did not differ across educational approaches. Our programmatic data offers preliminary evidence that a universal education approach can support and enhance equitable roll-out of LAI ART. Most patients with HIV are interested in learning more about LAI ART.