“A Dream Come True”: Perspectives on Long-Acting Injectable Antiretroviral Therapy among Female Sex Workers Living with HIV from the Dominican Republic and Tanzania

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Citation

Kerrigan, Deanna L.; Karver, Tahilin Sanchez; Muraleetharan, Ohvia; Savage, Virginia; Mbwambo, Jessie K.; Donastorg, Yeycy A.; Likindikoki, Samuel; Perez, Martha; Gomez, Hoisex; & Mantsios, Andrea R., et al. (2020). "A Dream Come True": Perspectives on Long-Acting Injectable Antiretroviral Therapy among Female Sex Workers Living with HIV from the Dominican Republic and Tanzania. PLOS ONE, 15(6), e0234666. PMCID: PMC7292359

Abstract

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.

URL

http://dx.doi.org/10.1371/journal.pone.0234666

Reference Type

Journal Article

Year Published

2020

Journal Title

PLOS ONE

Author(s)

Kerrigan, Deanna L.
Karver, Tahilin Sanchez
Muraleetharan, Ohvia
Savage, Virginia
Mbwambo, Jessie K.
Donastorg, Yeycy A.
Likindikoki, Samuel
Perez, Martha
Gomez, Hoisex
Mantsios, Andrea R.
Murray, Miranda
Beckham, S. Wilson
Davis, Wendy W.
Galai, Noya
Barrington, Clare

Article Type

Regular

PMCID

PMC7292359

Continent/Country

Dominican Republic
Tanzania

Sex/Gender

Women

ORCiD

Barrington - 0000-0001-7802-4051