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. 2022 Nov 21;75(Suppl 4):S549-S556.
doi: 10.1093/cid/ciac752.

Barriers to Uptake of Long-Acting Antiretroviral Products for Treatment and Prevention of HIV in Low- and Middle-Income Countries (LMICs)

Cissy Kityo  1 , Claudia P Cortes  2 , Nittaya Phanuphak  3 , Beatriz Grinsztejn  4 , Francois Venter  5
Affiliations

Barriers to Uptake of Long-Acting Antiretroviral Products for Treatment and Prevention of HIV in Low- and Middle-Income Countries (LMICs)

Cissy Kityo et al. Clin Infect Dis. .

Abstract

Long-acting injectable antiretroviral therapy (LA ART) has been found to be non-inferior to daily oral ART in phase 3 clinical trials and is poised to soon enter routine clinical care. This treatment modality has the potential to address many barriers to daily oral ART adherence among people living with human immunodeficiency virus (HIV) and for HIV Pre-Exposure prevention. Data from the Patient Reported Outcomes (PROs) showed high rates of satisfaction, acceptability, tolerability and preference for the LA regimen, compared with the daily oral treatment. Once LA ART is available, access and uptake will be limited because of current knowledge gaps in the use of these agents and multiple challenges many specific to low-income and middle-income countries, where the epidemic is most concentrated and HIV prevention and treatment options are limited. These gaps will lead to multiple systems-level and individual-level barriers to implementation. Anticipating and addressing these gaps and barriers will help fulfill the promise of these agents against the pandemic.

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Conflict of interest statement

Potential conflicts of interest. C. K. received research grant from Janssen, C. P. C. talks to MSD, ViiV, Pfizer, N. P. received research grant from the US NIH and Gilead Sciences and served as an External Expert for ViiV Healthcare. N. P. reports research funding from HTPN. F. V. reports research funding from the Bill and Melinda Gates Foundations, SA Medical Research Council, National Institutes for Health, AIDS Fonds, UNITAID, Foundation for Innovative New Diagnostics, the Children's Investment Fund Foundation ViiV Healthcare, J&J, Merck, and Gilead Sciences. He reports receiving payments for educational talks and advisory board membership for Gilead, ViiV Healthcare, Mylan, Merck, Adcock-Ingram, Aspen, Abbott, Roche, J&J, Sanofi, and Virology Education. He reports serving on the DSMB at NIH International and has held a leadership role with SAHCS and is currently a member of WHO and multiple guideline communities. C. P. C. reports receiving research funding from the NIH and The Ministry of Science, Technology, Knowledge and Innovation in Chile. She reports receiving payments for lectures from GSK and Merck. She is also a member of a governing council with the International AIDS Society. The other authors have reported no conflicts of interest. The authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

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