Patient preferences for antiretroviral therapy: effectiveness, quality of life, access and novel delivery methods
Authors Eaton EF, McDavid C, Banasiewicz MK, Mugavero MJ, Knight SJ
Received 26 May 2017
Accepted for publication 8 August 2017
Published 18 September 2017 Volume 2017:11 Pages 1585—1590
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Doris Leung
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Ellen F Eaton,1 Chastity McDavid,1 Mary Katy Banasiewicz,1 Michael J Mugavero,1 Sara J Knight2
1Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 2Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
Objective: The objective of this study was to understand patient preferences for contemporary antiretroviral therapy (ART) by focusing on three areas that have been understudied: minority patients (racial/ethnic and sexual minorities), experience with novel single-tablet regimens made available in the last 10 years, and patient concerns related to ART. The rationale was that identifying ART characteristics that are most desirable could inform provider prescribing practices, increase the use of patient-centered ART, maximize durability and ART adherence, and ultimately improve HIV outcomes, such as viral suppression and AIDS-related comorbidities.
Methods: We recruited English- and Spanish-speaking persons living with HIV (PLWH) who were ≥19 years of age or older and had initiated ART after January 1, 2006, until saturation was reached (n=28). We excluded patients who had started on ART more than 10 years earlier, in order to ensure responses were relevant to more contemporary ART regimens. We recruited racial/ethnic and sexual minorities, including men who have sex with men and transgender participants, to reflect the current HIV epidemic. Nominal group technique was used to identify and prioritize preferences and concerns. Multi-voting analysis was used to quantify responses from most important (5 points) to least important (1 point).
Results: For 28 diverse participants, clinical outcomes (162 points) and quality of life (120 points) were preferred. Hispanic participants were more concerned about accessibility than non-Hispanic (3.8 vs 1.9 average points/participant).
Discussion: HIV-infected persons prioritize access, clinical outcomes, and quality of life when considering contemporary ART treatment. Providers, insurers and policy makers should incorporate these preferences when making decisions about ART.
Keywords: HIV, preferences, immigrant, Hispanic, access to care
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