“A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania
BACKGROUND: Long-acting injectable antiretroviral therapy (LA ART) was found to be non-inferior to daily oral ART in Phase 3 clinical trials. LA ART may offer an important alternative for people living with HIV with challenges adhering to daily oral ART or preferences for non-pill-based regimens. ME...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292359/ https://www.ncbi.nlm.nih.gov/pubmed/32530939 http://dx.doi.org/10.1371/journal.pone.0234666 |
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author | Kerrigan, Deanna Sanchez Karver, Tahilin Muraleetharan, Ohvia Savage, Virginia Mbwambo, Jessie Donastorg, Yeycy Likindikoki, Samuel Perez, Martha Gomez, Hoisex Mantsios, Andrea Murray, Miranda Beckham, S. Wilson Davis, Wendy Galai, Noya Barrington, Clare |
author_facet | Kerrigan, Deanna Sanchez Karver, Tahilin Muraleetharan, Ohvia Savage, Virginia Mbwambo, Jessie Donastorg, Yeycy Likindikoki, Samuel Perez, Martha Gomez, Hoisex Mantsios, Andrea Murray, Miranda Beckham, S. Wilson Davis, Wendy Galai, Noya Barrington, Clare |
author_sort | Kerrigan, Deanna |
collection | PubMed |
description | BACKGROUND: Long-acting injectable antiretroviral therapy (LA ART) was found to be non-inferior to daily oral ART in Phase 3 clinical trials. LA ART may offer an important alternative for people living with HIV with challenges adhering to daily oral ART or preferences for non-pill-based regimens. METHODS: Using a mixed methods approach integrating survey, in-depth interview and biological data from female sex workers (FSW) living with HIV in Tanzania (N = 208) and the Dominican Republic (DR) (N = 201), we assessed factors associated with the potential likelihood of LA ART use if it were available. We conducted multivariate logistic regression and thematic content analysis. RESULTS: Likelihood of LA ART use was high with 84.92% of FSW from the DR and 92.27% of FSW from Tanzania reporting they would be “likely” or “very likely” to use LA ART if available (p = 0.02). In Tanzania better HIV-related patient-provider communication (AOR 4.58; 95% CI 1.90–11.05) and quality of HIV clinical care (AOR 3.68; 95% CI 1.05–12.86) were positively associated with the high likelihood of LA ART use. In the DR, easier clinic access was associated with a higher likelihood of LA ART use (AOR 3.04; 95% CI 1.41–6.56), as was greater monthly income from sex work (AOR 2.37; 95% CI 1.27–4.41). In both settings, years on ART was significantly associated with a strong likelihood of LA ART use (TZ: AOR 1.16 per year; 95% CI 1.00–1.34/DR: AOR 1.07 per year; 95% CI 1.00–1.14). Qualitative findings underscored enthusiasm for LA ART and reinforced its potential to address sex work-specific barriers to daily oral ART adherence including work-related schedules and substance use. CONCLUSIONS: We found a high likelihood of LA ART use if available among FSW in two diverse settings and documented barriers to future uptake. Community-driven approaches which include tailored health education and improved patient-provider communication and quality of care, as well as strategies to facilitate appointment adherence are needed to optimize LA ART use among FSW. |
format | Online Article Text |
id | pubmed-7292359 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-72923592020-06-18 “A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania Kerrigan, Deanna Sanchez Karver, Tahilin Muraleetharan, Ohvia Savage, Virginia Mbwambo, Jessie Donastorg, Yeycy Likindikoki, Samuel Perez, Martha Gomez, Hoisex Mantsios, Andrea Murray, Miranda Beckham, S. Wilson Davis, Wendy Galai, Noya Barrington, Clare PLoS One Research Article BACKGROUND: Long-acting injectable antiretroviral therapy (LA ART) was found to be non-inferior to daily oral ART in Phase 3 clinical trials. LA ART may offer an important alternative for people living with HIV with challenges adhering to daily oral ART or preferences for non-pill-based regimens. METHODS: Using a mixed methods approach integrating survey, in-depth interview and biological data from female sex workers (FSW) living with HIV in Tanzania (N = 208) and the Dominican Republic (DR) (N = 201), we assessed factors associated with the potential likelihood of LA ART use if it were available. We conducted multivariate logistic regression and thematic content analysis. RESULTS: Likelihood of LA ART use was high with 84.92% of FSW from the DR and 92.27% of FSW from Tanzania reporting they would be “likely” or “very likely” to use LA ART if available (p = 0.02). In Tanzania better HIV-related patient-provider communication (AOR 4.58; 95% CI 1.90–11.05) and quality of HIV clinical care (AOR 3.68; 95% CI 1.05–12.86) were positively associated with the high likelihood of LA ART use. In the DR, easier clinic access was associated with a higher likelihood of LA ART use (AOR 3.04; 95% CI 1.41–6.56), as was greater monthly income from sex work (AOR 2.37; 95% CI 1.27–4.41). In both settings, years on ART was significantly associated with a strong likelihood of LA ART use (TZ: AOR 1.16 per year; 95% CI 1.00–1.34/DR: AOR 1.07 per year; 95% CI 1.00–1.14). Qualitative findings underscored enthusiasm for LA ART and reinforced its potential to address sex work-specific barriers to daily oral ART adherence including work-related schedules and substance use. CONCLUSIONS: We found a high likelihood of LA ART use if available among FSW in two diverse settings and documented barriers to future uptake. Community-driven approaches which include tailored health education and improved patient-provider communication and quality of care, as well as strategies to facilitate appointment adherence are needed to optimize LA ART use among FSW. Public Library of Science 2020-06-12 /pmc/articles/PMC7292359/ /pubmed/32530939 http://dx.doi.org/10.1371/journal.pone.0234666 Text en © 2020 Kerrigan et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kerrigan, Deanna Sanchez Karver, Tahilin Muraleetharan, Ohvia Savage, Virginia Mbwambo, Jessie Donastorg, Yeycy Likindikoki, Samuel Perez, Martha Gomez, Hoisex Mantsios, Andrea Murray, Miranda Beckham, S. Wilson Davis, Wendy Galai, Noya Barrington, Clare “A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania |
title | “A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania |
title_full | “A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania |
title_fullStr | “A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania |
title_full_unstemmed | “A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania |
title_short | “A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania |
title_sort | “a dream come true”: perspectives on long-acting injectable antiretroviral therapy among female sex workers living with hiv from the dominican republic and tanzania |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292359/ https://www.ncbi.nlm.nih.gov/pubmed/32530939 http://dx.doi.org/10.1371/journal.pone.0234666 |
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