Interest, Preference, and Uptake of Long Acting ART among PLWH in Florida

佛罗里达州 PLWH 中的长效 ART 的兴趣、偏好和采用情况

• 批准号: 10547990
• 负责人: Rebecca J Fisk
• 金额: $ 4.09万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-16 至 2024-08-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10547990
• 关键词: Adherence; Administrator; Adult; Affect; Alcohol consumption; Alcohols; Attitude; Caring; Characteristics; Cohort Studies; Collaborations; Data; Data Analyses; Data Collection; Decision Making; Development; Enrollment; Epidemic; Failure; Florida; Formulation; Funding; Goals; Grant; HIV; Health; Health behavior; Healthcare Systems; Incidence; Individual; Injectable; Interview; Lead; Learning Skill; Measures; Modeling; Modernization; Outcome; Patients; Perception; Persons; Pharmaceutical Preparations; Policies; Population; Population Heterogeneity; Provider; Recommendation; Regimen; Research; Risk; Stigmatization; Substance Use Disorder; Translations; United States; United States National Institutes of Health; Viral; Viral Load result; Visit; alcohol abuse therapy; alcohol availability; alcohol research; antiretroviral therapy; care providers; career; career development; contextual factors; design; drinking; experience; experimental study; health care cost/financing; high risk drinking; improved; insight; interest; novel; optimism; pill; preference; programs; responsible research conduct; side effect; skills; social; social stigma; substance use; substance use treatment; success; system-level barriers; therapy adherence; tool; transmission process; uptake

Project Summary A newly approved long-acting injectable (LAI) form of antiretroviral therapy (ART) is now available, and several other long-acting formulations are in development. These provide new tools to achieve the ambitious goals described in the initiative to End the HIV Epidemic in the United States by helping more people living with HIV (PLWH) achieve durable viral suppression. Because alcohol use is associated with decreased adherence, these treatments may be especially helpful among PLWH who drink. The impact of these exciting new treatments will be proportional to their uptake, which will be affected by both individual preferences and systemic factors. Previous studies have shown high levels of interest in LAI-ART but have not generally accounted for systemic factors that may hinder LAI-ART uptake. The long-term goal of the proposed research is to inform programs to improve ART adherence for PLWH. To help achieve this goal, the aims of this F31 grant are to: 1) determine which individual- and interpersonal-level factors are associated with preferences for a quarterly LAI-ART over taking daily pills in PLWH, focusing on populations with lower ART adherence and at- risk drinking, using existing data from the Florida Cohort study; 2) describe PLWH’s preferences for long-acting ART (LA-ART) formulations and determine which treatment attributes drive these preferences by implementing a best-best discrete choice experiment and explore whether preferences vary by drinking status and viral suppression; and 3) to conduct in-depth qualitative interviews with 20 stakeholders involved in HIV medication procurement and prescribing (e.g., HIV-care providers and clinician administrators) to gain insight into their attitudes towards and prescribing preferences of different LA-ART formulations, how these are impacted by patients’ alcohol use, systems-level barriers and facilitators of prescribing LA-ART, and how these visits can be used to increase the accessibility of alcohol-related care. Conducting this study will help me develop cross- cutting skills to achieve my long-term career goals of designing programs to improve health outcomes for PLWH, especially those who drink by focusing on: 1) measuring of individual preferences and decision-making related to health, 2) obtaining expertise in qualitative data collection and analysis, 3) gaining a better understanding of public healthcare financing related to HIV treatment and substance use, 4) learning skills related to professional and career development, and 5) responsible conduct of research. This study will leverage the ongoing Florida Cohort study, which is enrolling a diverse population of adult PLWH, and collaborations between Southern HIV and Alcohol Research Consortium and the Florida Department of Health and HIV care providers. These data can inform funding allocation and policy changes to support these ART preferences and can be extrapolated to treatments for alcohol and other substance use disorders to help focus development of novel medications or develop programs to help better integrate HIV care and alcohol-related treatment.

项目摘要 一种新批准的长效注射（LAI）形式的抗逆转录病毒疗法（ART）现已上市， 其他长效制剂正在开发中。这些为实现雄心勃勃的目标提供了新的工具 通过帮助更多的艾滋病毒感染者来结束美国艾滋病毒流行的倡议中描述的 （PLWH）实现持久的病毒抑制。因为酒精的使用与依从性的降低有关， 这些治疗对饮酒的艾滋病病毒携带者特别有帮助。这些令人兴奋的新的影响 治疗将与他们的吸收成正比，这将受到个人偏好和 系统性因素。先前的研究显示对LAI-ART的兴趣很高，但一般来说， 解释了可能阻碍LAI-ART吸收的系统性因素。拟议研究的长期目标 是为提高艾滋病毒携带者抗逆转录病毒治疗依从性的项目提供信息。为了帮助实现这一目标，F31的目标是 （1）确定哪些个人和人际因素与偏好有关， 在PLWH中，每季度进行一次LAI-ART，重点关注ART依从性较低的人群， 风险饮酒，使用现有数据从佛罗里达队列研究; 2）描述PLWH的偏好长效 ART（LA-ART）配方，并通过实施 最佳离散选择实验，并探讨偏好是否因饮酒状况和病毒而异 抑制;和3）与20名参与艾滋病毒药物治疗的利益相关者进行深入的定性访谈 采购和开处方（例如，艾滋病护理提供者和临床医生管理人员），以深入了解他们的 对不同LA-ART制剂的态度和处方偏好，这些如何受到 患者的酒精使用，系统水平的障碍和处方LA-ART的促进者，以及这些访问如何 用于提高酒精相关护理的可及性。进行这项研究将有助于我发展跨- 削减技能，以实现我的长期职业目标，设计方案，以改善健康结果， PLWH，特别是那些专注于饮酒的人：1）测量个人偏好和决策 2）获得定性数据收集和分析方面的专业知识，3）获得更好的 了解与艾滋病毒治疗和药物使用相关的公共医疗保健融资，4）学习技能 与专业和职业发展有关，以及5）负责任地进行研究。本研究将 利用正在进行的佛罗里达队列研究，该研究正在招募不同的成年PLWH人群， 南方艾滋病毒和酒精研究联盟和佛罗里达卫生部之间的合作 和艾滋病护理提供者。这些数据可以为资金分配和政策变化提供信息，以支持这些ART 偏好，并可以外推到酒精和其他物质使用障碍的治疗，以帮助重点 开发新的药物或制定计划，以帮助更好地整合艾滋病毒护理和酒精相关的 治疗