A Conjoint Analysis of the Acceptability of Targeted Long-Acting Injectable Antiretroviral Therapy Among Persons Living with HIV in the US
A Conjoint Analysis of the Acceptability of Targeted Long-Acting Injectable Antiretroviral Therapy Among Persons Living with HIV in the US
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DOI：
10.1007/s10461-019-02701-7
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发表时间：
2019-10-26
影响因子：
4.4
通讯作者：
Collier, Ann C.
中科院分区：
文献类型：
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作者：
Simoni, Jane M.;Tapia, Kenneth;Collier, Ann C.
随着长效注射抗逆转录病毒疗法可能成为艾滋病毒感染者的一种治疗选择，评估其在潜在最终用户中的可接受性至关重要。基于形成性定性工作和我们自己正在进行的纳米混悬液制剂中靶向长效产品的开发，我们创建了八个假设的药物方案，这些方案沿着六个二分属性变化：给药位置（家庭与[vs.]临床）、给药频率（每2周一次对1周一次）、每剂量注射（一次对两次）、注射疼痛（轻度对中度）、注射部位反应（轻度对中度）和有效性（更好对与药丸相同）。来自华盛顿州西雅图和加利福尼亚州滨江的三家门诊护理诊所的PLWH评定了可接受性（即，愿意尝试每种假设的药物）从0（非常不可能）到100（非常可能）。在联合分析中，我们研究了可接受性的水平和相关性，每个属性对整体可接受性的影响，以及这种影响的调节因素。参与者（中位年龄52岁; 71%男性，34%白色，36%黑人/非裔美国人，20%西班牙裔）将8种情景的可接受性从47.8（标准差[SD] = 37.0）至68.8（SD = 34.1），有效性（影响评分= 7.3，SD = 18.7，p = 0.005）和给药频率（影响评分= 5.7，SD = 19.6，p = 0.034）是对可接受性有显著影响的唯一属性。根据任何参与者的社会人口统计学或其他特征，总体可接受性无统计学显著差异;然而，性别、教育、就业状况、注射经验和仇恨/避免注射会缓和一些影响。所提出的靶向长效抗逆转录病毒治疗的总体可接受性是适度的，上级有效性和较低的给药频率对可接受性影响最大。未来的可接受性研究应继续使用全方位的联合分析和其他技术来评估开发中的特定产品。
With long-acting injectable antiretroviral therapy likely to be a treatment option for people living with HIV (PLWH), it is critical to assess its acceptability among potential end-users. Based on formative qualitative work and our own ongoing development of targeted long-acting products in nanosuspension formulations, we created eight hypothetical medication scenarios varying along six dichotomous attributes: administration location (home versus [vs.] clinic), dosing frequency (every 2 weeks vs. 1 week), injections per dose (one vs. two), injection pain (mild vs. moderate), injection site reaction (mild vs. moderate), and effectiveness (better vs. same as pills). PLWH from three outpatient care clinics in Seattle, WA and Riverside, CA rated acceptability (i.e., willingness to try each hypothetical medication) from 0 (very unlikely) to 100 (very likely). In conjoint analyses, we examined level and correlates of acceptability, the impact of each attribute on overall acceptability, and moderators of this effect. Participants (median age 52 years; 71% male, 34% White, 36% Black/African American, 20% Hispanic) rated acceptability of the 8 scenarios from 47.8 (standard deviation [SD] = 37.0) to 68.8 (SD = 34.1), with effectiveness (impact score = 7.3, SD = 18.7, p = 0.005) and dosing frequency (impact score = 5.7, SD = 19.6, p = 0.034) the only attributes with a significant impact on acceptability. There were no statistically significant differences in overall acceptability according to any participant socio-demographic or other characteristic; however, gender, education, employment status, and experience with and hatred/avoidance of injections moderated some effects. Overall acceptability for targeted long-acting antiretroviral treatment as proposed was modest, with superior effectiveness and lower dosing frequency most impactful on acceptability. Future acceptability research should continue to evaluate specific products in development with a full range of conjoint analytic and other techniques.