Long-acting drugs: people's expectations and physicians' preparedness. Are we readying to manage it? An Italian survey

Abstract

To evaluate patients' expectations regarding long-acting antiretroviral agents and preferences about where to receive them. Multicenter cross-sectional survey-based study. Through an online survey, we asked people living with human immunodeficiency virus to judge their relationship with daily antiretroviral therapy (ART) and to give their opinion about long-acting drugs. We also collected data regarding the age of the patients, their site of follow-up, time since the diagnosis, and compliance to ART. Two hundred forty-two patients aged 18 to 79 years were included in the study: 58 (24%) females, 182 (75.2%) males, and 2 (0.8%) male-to-female transgenders. 81.8% of the said population had a good relationship with ART. 33.6% of them consider daily ART an obligation and a restriction to their freedom. One hundred forty-three (59.1%) patients already knew about long-acting drugs before our interview, and 215 (88.8%) patients were interested in it. One hundred fifty-six (64.4%) interviewees said they would still be interested in hospital-available injective long-acting drugs, although 57.9% of the patients would rather receive them at home. The data emerging from our survey reveal that around 90% of the people living with HIV are interested in changing their actual treatment with a long-acting one. Moreover, for the first time to our knowledge, such a high number of patients showed an enthusiastic response to the new opportunity to be treated directly at home. The introduction of these new drugs could be revolutionary and represents an important step toward treatment simplification.

Figure 1.

The bar graph in this figure shows the distribution of the patients by age. Most of the patients answering the questionnaire were middle-aged (40–59 yr). Thirteen patients (5.4%) were 18–29 yr old; 46 patients (19.0%) were 30–39 yr old; 72 patients (29.8%) were 40–49 yr old; 83 patients (34.3%) were 50–59 yr old; 21 patients (8.7%) were 60–69 yr old; 7 patients (2.9%) were 70–79 yr old.

Figure 2.

The bar graph in this figure shows the distribution of the patients by time since HIV diagnosis. Forty-five patients (18.6%) had their diagnosis <5 yr before the survey; 57 (23.6%) had their diagnosis 5–10 yr before; 64 (26.4%) had their diagnosis 10 to 20 yr before; 44 (18.2%) had their diagnosis 20 to 30 yr before; 32 patients (13.2%) had their diagnosis >30 yr before.

Figure 3.

This figure shows the frequency of the answers to questions 10 to 15 of the survey (Supplemental Material, Supplemental Digital Content, http://links.lww.com/MD/H25). It is shown that (A) 152 (62.8%) patients say they are aware about their infection; (B) 114 (47.1%) patients does not feel in a particular way when they think about their infection; (C) 124 (51.2%) patients think that their relationships with those around them were affected by the diagnosis; (D) while 152 (62.8%) patients say they were never discriminated because of the infection, 35 (14.5%) and 55 (22.7%) felt discriminated because of the infection once or more than once, respectively; (E) for the majority of the patients interviewed, cART represents safety (57.4%) or a chance (24.4%); but when asking the interviewees what they think about taking ART daily, 43 of them (17.8%) say that it is a duty.

Figure 4.

This figure shows how the patients answered the final 5 questions of the survey (Supplemental Material, Supplemental Digital Content, http://links.lww.com/MD/H25).