The worldview in relation to patient care has shifted from conquering diseases to improving overall wellbeing and quality of life. We examined treatment aspirations among people living with HIV (PLHIV).

In all, 2389 PLHIV were surveyed in the 25-country 2019 Positive Perspectives Study. Descriptive and multivariable analyses were used to explore attitudes towards treatment.

Participants were from: Northern America (USA, Canada), 21.8% (520/2389); Europe, 46.8% (1119/2389); and other international regions, 31.4% (750/2389). Factors associated with some level of dissatisfaction with HIV medication among those otherwise fully satisfied with their HIV management included being on a multi-tablet regimen (AOR=2.76; 95% CI: 1.93–3.96), reporting polypharmacy (AOR=2.10; 95% CI: 1.45–3.03), and experiencing side effects from current HIV medication (AOR=2.12; 95% CI: 1.49–3.02). Of seven improvements to HIV medications assessed, the percentage ranking each attribute, as the first or second most important, was: ‘reduced long-term impact on my body’ (46.7%); ‘longer-lasting medicine so I don’t have to take it every day’ (43.1%); ‘fewer side effects’ (40.5%); ‘less HIV medicine each day but just as effective’ (25.4%); ‘less chance of affecting other medicines’ (21.6%); ‘no food restrictions/ requirements’ (14.0%); and ‘smaller pills’ (8.7%). Overall, 77.1% (1842/2389) believed ‘future advances in HIV treatment will improve my overall wellbeing’, 72.2% (1726/2389) were ‘open to taking an HIV treatment composed of fewer medicines’, while 54.7% (1306/2389) expressed openness towards longer-acting (non-daily) HIV medication. Compared to those not fully satisfied with either their HIV medication or management, those fully satisfied with both reported significantly higher prevalence of optimal treatment adherence (89.2% [372/417] vs 69.5% [763/1098]) and optimal overall health (70.3% [293/417] vs 47.8% [525/1098]) (all p<0.001).

Many PLHIV perceived gaps in their care and aspired for novel treatments. Providing flexible treatment options can help patients across the spectrum of unmet needs and improve health-related quality of life.

Statistical analyses and medical services were provided 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. E. Castellanos and B. Allan report personal fees from ViiV Healthcare during the conduct of the study, and personal fees from ViiV Healthcare outside the submitted work. N. Van de Velde reports other grants from ViiV Healthcare and GlaxoSmithKline outside the submitted work. G. M. Corbelli reports personal fees from ViiV Healthcare during the conduct of the study, and personal fees from ViiV Healthcare and HIV Vaccine Trials Network outside the submitted work. W.D. Hardy reports personal fees from ViiV Healthcare, during the conduct of the study; personal fees from ViiV Healthcare, personal fees from Advisory Boards, personal fees from Merck, personal fees from Gilead Sciences, outside the submitted work. P. de los Rios and B. Young report other grants from ViiV Healthcare during the conduct of the study, as well as outside the submitted work. A. Eremin and C. Okoli report personal fees from ViiV Healthcare, during the conduct of the study. P. de los Rios, C. Okoli, B. Young, and N. Van de Velde are employees of ViiV Healthcare.
This work was supported by ViiV Healthcare.
PD, CO, BY and NV conceptualized the study. All authors contributed to study design, analyses, drafting of the manuscript, and substantial revisions. All authors gave final approval for the manuscript to be submitted.
Not commissioned; externally peer reviewed.
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