Current antiretroviral therapies (ARTs) require daily oral dosing, which is a challenge for some people living with HIV (PLHIV). Measures of treatment needs that are associated with daily oral ARTs have been identified in studies/interviews with healthcare professionals (HCPs) and PLHIV, and are grouped in four main categories: 1) medical conditions interfering with daily oral administration, 2) suboptimal adherence, 3) confidentiality concerns, and 4) emotional wellbeing related to daily tablet requirements. We quantified these categories to assess the potential benefits of alternatives to daily oral ARTs such as long-acting injectable regimens.

Two separate online studies were completed by HCPs (n=120) and PLHIV (n=698) in France, Germany, Italy and the UK, in 2019. HCPs reported the number and percentage of their patients with challenges; unit of analysis among PLHIV was the respondents (%). Descriptive analyses were performed with R 3.6.1.

HIV physicians reported managing a mean of 299 (SD=177) patients, of whom 85.7% were on ART. Among PLHIV, 98.6% (688/698) were currently on ART, with mean age of 40.9 (SD=12.0) years, and 66.4% men. HCPs estimated that 10–15% of their patients were affected by each medical condition identified as interfering with daily oral administration. HCPs further estimated that 33.6% of their patients were suboptimally adherent. ‘Non-adherence for any non-medical reason’ was reported by HCPs as the primary cause of virologic failure. Of surveyed PLHIV on ART, 43.3% (298/688) reported hiding their medication and 29.7% (204/688) indicated they had never shared their HIV status with others. Furthermore, some PLHIV reported that having to remember to dose at the right time every day was stressful (27.3%; 188/688) and many saw their tablets as a daily reminder of HIV (45.1%; 310/688).

A significant proportion of PLHIV struggle with daily oral ART because of medical and/or HIV-specific issues. Alternatives to daily oral ARTs have the potential to improve treatment adherence and quality of life in PLHIV.

Data collection was supported by Ipsos Healthcare. Data analyses and medical writing services were supported by Zatum LLC.
The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. L. A. Clark was a full-time employee at Ipsos Insights, LLC, during the conduct of the study. C. Karki and J. Noone report personal fees from Ipsos Insights, LLC during the conduct of the study. L. Roustand, V. Chounta and N. Van de Velde report other grants from GlaxoSmithKline, outside the submitted work. L. Finkielsztejn, V. Chounta and N. Van de Velde report personal fees from ViiV Healthcare, outside the submitted work. G. Nachbaur reports that she is an employee and holds shares of GlaxoSmithKline, during the conduct of the study.
The research was funded by ViiV Healthcare.
Not commissioned; externally peer reviewed.
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