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Expanding the Menu of HIV Prevention Options: A Qualitative Study of Experiences with Long-Acting Injectable Cabotegravir as PrEP in the Context of a Phase II Trial in the United States

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Abstract

Adherence challenges with oral pre-exposure prophylaxis have stimulated interest in alternate modes of administration including long-acting injections. We conducted 30 in-depth interviews with 26 male trial participants and 4 clinical providers in a Phase IIa study (ÉCLAIR) evaluating the use of long-acting cabotegravir (CAB-LA) injections in New York and San Francisco. Interviews exploring attitudes and experiences with CAB-LA were audiotaped, transcribed, and analyzed using thematic content analysis. Despite a high frequency of some level of side effects, almost all participants reported being interested in continuing with CAB-LA, versus a daily oral, due to its convenience and the perceived advantage of not worrying about adhering to pills. Providers reinforced the importance of CAB-LA as a prevention option and the need for guidelines to assist patient decision-making. Further research is needed on the acceptability of CAB-LA among men and women at higher risk for HIV in different settings.

Resumen

Los retos de adherencia con la profilaxis oral previa a la exposición (PrEP, por sus siglas en inglés) han estimulado el interés en modos alternos de administración incluyendo inyecciones de acción prolongada. Realizamos 30 entrevistas en profundidad con 26 participantes masculinos del ensayo y 4 proveedores clínicos en un estudio de Fase IIa (ÉCLAIR) que evaluó el uso de inyecciones de acción prolongada de cabotegravir (CAB-LA) en Nueva York y San Francisco. Las entrevistas que exploran actitudes y experiencias con CAB-LA fueron grabadas, transcritas y analizadas usando análisis de contenido temático. A pesar de una alta frecuencia de algún nivel de efectos secundarios, casi todos los participantes informaron estar interesados en continuar con CAB-LA, frente a una pastilla diaria, debido a su conveniencia y la ventaja percibida de no preocuparse por adherirse a las pastillas. Los proveedores reforzaron la importancia de CAB-LA como una opción de prevención y la necesidad de directrices para ayudar a los pacientes en la toma de decisiones. Se necesita más investigación sobre la aceptabilidad de CAB-LA entre hombres y mujeres con mayor riesgo de VIH en diferentes contextos.

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Funding

This study was funded by ViiV Healthcare.

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Authors and Affiliations

  1. Johns Hopkins Bloomberg School of Public Health, Health, Behavior & Society, 624 N Broadway St. HH 257, Baltimore, MD, 21205, USA

    D. Kerrigan, A. Mantsios, S. W. Beckham & P. Hammond

  2. Gladstone Center for AIDS Research, University of California, San Francisco, USA

    R. Grant & P. Defechereux

  3. Aaron Diamond AIDS Research Center, An Affiliate of the Rockefeller University, New York, USA

    M. Markowitz & M. La Mar

  4. ViiV Healthcare, Raleigh-Durham, USA

    D. Margolis

  5. ViiV Healthcare, London, UK

    M. Murray

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  1. D. Kerrigan
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  2. A. Mantsios
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  3. R. Grant
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  4. M. Markowitz
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  5. P. Defechereux
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  8. P. Hammond
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  9. D. Margolis
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  10. M. Murray
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Corresponding author

Correspondence to D. Kerrigan.

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Conflict of interest

Deanna Kerrigan received support via a GSK contract. Andrea Mantsios received support via a GSK contract. Robert Grant was an investigator on trials supported in part by ViiV/GSK. Martin Markowitz was an investigator on trials supported in part by ViiV/GSK. Patricia Defechereux was staff on trials supported in part by ViiV/GSK. Melissa La Mar was staff on trials supported in part by ViiV/GSK. Sarah Beckham received support via a GSK contract. Paige Hammond received support via a GSK contract. David Margolis is an employee of ViiV Healthcare. Miranda Murray is an employee of ViiV Healthcare.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kerrigan, D., Mantsios, A., Grant, R. et al. Expanding the Menu of HIV Prevention Options: A Qualitative Study of Experiences with Long-Acting Injectable Cabotegravir as PrEP in the Context of a Phase II Trial in the United States. AIDS Behav 22, 3540–3549 (2018). https://doi.org/10.1007/s10461-017-2017-x

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