"A dream come true": Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania.

Autor: Kerrigan D; Department of Sociology, American University, Washington, DC, United States of America., Sanchez Karver T; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America., Muraleetharan O; Department of Health Policy, Yale University, New Haven, Connecticut, United States of America., Savage V; Department of Health Behavior, University of North Carolina, Chapel Hill, North Carolina, United States of America., Mbwambo J; Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Donastorg Y; HIV Vaccine Trials Research Unit, Instituto Dermatológico y Cirugía de la Piel, Santo Domingo, Dominican Republic., Likindikoki S; Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Perez M; HIV Vaccine Trials Research Unit, Instituto Dermatológico y Cirugía de la Piel, Santo Domingo, Dominican Republic., Gomez H; HIV Vaccine Trials Research Unit, Instituto Dermatológico y Cirugía de la Piel, Santo Domingo, Dominican Republic., Mantsios A; Public Health Innovation and Action, New York, New York, United States of America., Murray M; Health Analytics and Outcomes, London, United Kingdom., Beckham SW; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America., Davis W; Department of Sociology, American University, Washington, DC, United States of America., Galai N; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.; Department of Statistics, University of Haifa, Mt Carmel, Israel., Barrington C; Department of Health Behavior, University of North Carolina, Chapel Hill, North Carolina, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2020 Jun 12; Vol. 15 (6), pp. e0234666. Date of Electronic Publication: 2020 Jun 12 (Print Publication: 2020).
DOI: 10.1371/journal.pone.0234666
Abstrakt: 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.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje