EPB185

PREFERENCE FOR LONG ACTING INJECTABLE (LAI)

ANTIRETROVIRALS FOR HIV TREATMENT OR PREP IN ARGENTINA
Sciannameo S1, Zalazar V1, Spadaccini L1, Duarte M1, Aristegui I1,2, Cahn P1, Sued O3.
1 Fundación Huésped, Research Department, Buenos Aires, Argentina. 2 Universidad de Palermo, Buenos Aires, Argentina 3 PAHO HT Unit

BACKGROUND
Table 1. Characteristics of the sample and correlates associated with the preference of injectables for
New ways of delivering drugs have displayed a whole range of possibilities for ART in people living with HIV (n= 804) and for PrEP in people without HIV (n= 872).
antiretroviral administration for HIV treatment (ART) and pre-exposure
prophylaxis (PrEP), from oral daily treatment with fix-dose combinations of     

several drugs in a single pill, to long acting injectable (LAI) treatments.   Injectables ART, n (%)
Statistical tests
  Injectable PrEP, n (%)
Statistical tests

Information on LAI preference is limited in Latin America. This study assessed Characteristic
Total PLWH Yes No   Total HIV-neg Yes No  

preference of antiretroviral administration routes for HIV treatment (ART) or Pre- n= 804 n = 736 (91.5) n = 68 (8.5)
 
n= 872 n = 593 (68) n = 279 (32)
 

Exposure Prophylaxis (PrEP) in Argentina. Age, median (IQR) 35 (30- 43) 35 (30 – 42) 40 (31 – 50) U=20260.00* 31 (26- 38) 31 (26 – 38) 31 (26 – 38)  

Gender                 
 

METHODS Cisgender women 203 (26.8%) 176 (25.3%) 27 (44.3%) X2 = 10,289, df =1** 583 (70.2) 401 (70.8) 182 (68.7)

An online survey was conducted, addressing HIV negative people willing to use Cisgender Men 554 (73.2%) 520 (74.7%) 34 (55.7%)   248 (29.8) 165 (29.2) 83 (31.3)  

Gender + sexual orientation                

PrEP and also PLWH already on oral treatment. The sample included people over  

18 years of age and living in Argentina, who were reached using the social media
Heterosexual Women 184 (22.9) 160 (21.7) 24 (35.3) X2 = 19,023, df =4** 488 (56) 334 (56.3) 154 (55.2)

 
accounts of the HIV organization which carried on the research. Medians and
LBQ Women 19 (2.4) 16 (2.2) 3 (4.4) 95(10.9) 67 (11.3) 28 (10.0)  
Heterosexual Men 52 (6.5) 44 (6.0) 8 (11.8)   33 (3.8) 24 (4.0) 9 (3.2)  

interquartile ranges (IQR) were calculated for continuous variables, and GBQ Men
Trans Het+ LGBQ
502 (62.4)
47 (5.8)
476 (64.7)
40 (5.4)
26 (38.2)
7 (10.3)
 
 
215 (24.7)
41 (4.7)
141 (23.8)
27 (4.6)
74 (26.5)
14 (5.0)
 
 

frequencies and proportions were obtained for categorical variables. Categorical Nationality
Argentina
 
750 (93.3)
 
685 (93.1)
 
65 (95.6)
 
 
 
825 (94.6) 559 (94.3)
   
266 (95.3)
 
 

variables were compared using Pearson chi‐square test and continuous Other 54 (6.7) 51 (6.9) 3 (4.4)   47 (5.4) 34 (5.7) 13 (4.7)  
Education Level                
variables, using Mann-Whitney U test. For variables composed of more than two
groups, Z-score was calculated using a modified Bonferroni procedure to
Secondary school or higher 736 (91.8) 683 (93.1) 53 (77.9) X2 = 18,816, df =1** 843 (97.2) 572 (97.1) 271 (97.5)  

 
determine differences between groups. Up to incomplete secondary school 66 (8.2) 51 (6.9) 15 (22.1) 24 (2.8) 17 (2.9) 7 (2.5)  

Substance use                
  Yes 152 (18.9) 141 (19.2) 11 (16.2)   199 (22.9) 137 (23.1) 62 (22.2)  

RESULTS   No 652 (81.1) 595 (80.8) 57 (83.8)   673 (77.2) 456 (76.9) 217 (77.8)  

Of the 1676 respondents 804 were people living with HIV (PLWH) and 872 were
Symptoms of depression                

  Yes 241 (30.0) 227 (30.8) 14 (20.6)   295 (33.8) 209 (35.2) 86 (30.8)  

HIV-negative. Participants were young (Median = 33 years, IQR = 28–41), 47.8%   No 563 (70.0) 509 (69.2) 54 (79.4)   577 (66.2) 384 (64.8) 193 (69.2)  

self-identified as cisgender men, 46,9% as cisgender women and only 5.3% as Injection experience         603 (70.4) 432 (74.0) 171 (62.6) X2 = 11,462, df =1**

transgender or non-binary people (TNB). Of the cisgender women, 85.5% Good 662 (78.8) 576 (79.4) 46 (71.9)   254 (29.6) 152 (26.0) 102 (37.4)  
Bad/Indifferent 167 (21.2) 149 (20.6) 18 (28.1)          
identified as heterosexuals (HW) and 14.5% as lesbian, bisexual or queer (LBQ).
Take ART/ other treatment for HIV-neg         346 (39.7) 232 (39.1) 114 (40.9)  
Among cisgender men, 89.4% identified as gay, bisexual and queer (GBQ) and   Yes 788 (98.0) 722 (98.1) 66 (97.1)   526 (60.3) 361 (60.9) 165 (59.1)  

10.6% self-defined as heterosexuals (HM). Almost all respondents (94.2%)   No 16 (2.0) 14 (1.9) 2 (2.9)          

completed secondary school, 94% were born in Argentina, and 98.2% had
No. ART pills per day         - - - -
One 331 (42.0) 305 (42.2) 26 (39.4)   - - - -

received injectable medication before. Two or more

Condom use
457 (58.0)

 
417 (57.8)

 
40 (60.6)

 
 

 
-

 
-

 
-

 
-

 
Always - - - - 336 (39.4) 225 (38.7) 111 (41.1)  
Usually - - - - 309 (36.3) 214 (36.8) 95 (35.2)  

Among the 804 PLWH (Table 1), 98% were receiving HIV treatment, of which Sometimes
Never
- - - - 102 (2.0)
105 (12.3)
70 (12.0)
73 (12.5)
32 (11.9)
32 (11.9)
 
 
58% reported taking an ART consisting of two or more pills per day. Regarding
       
Heard about PrEP                

the preference for ART route, almost all PLWH (91.5%) preferred LAI-ART (13.4%
  Yes - - - - 465 (53.3) 308 (51.9) 157 (56.3)  
  No - - - - 407 (46.7) 285 (48.1) 122 (43.7)  

of them injectable every two months and 78.1% every 6 months) and 4.1% to **p<.01, *p<.05

continue with pills. Preference of LAI-ART was high in all gender/sexual Figure 1. Reasons to choose injectable or pills for ART
orientation groups: 94.8% gay GBQ, 87% HW, 85.1% TNB, 84.6% HM and 84.2%
LBQ. When analyzing the correlates of preference for LAI-ART, it was observed The discomfort of having to take pills every day 52.8%

that cisgender men were more likely than women to be willing to use LAI-ART (X2 I don't mind getting injections 42.6%

= 10,289, df =1, p=.001). Also, a significant difference was foung between

gender/sexual orientation groups, showing a positive association between LAI-
I think it would improve my quality of life 40.3%

ART preference and identifying as GBQ (Z = 4,3; p = .000) and negative for Discretion and privacy for not having to carry pills with me 36.6%

identifying as HW (Z = -2,5 ; p=.000). However, due to the unbalanced sample Forget about HIV for a while if I don't have to take pills every day

(TNB, HM and LBQ percentages were too small) the statistical analysis was not It bothers me to remember to take pills 21.7%

reliable. Moreover, people who chose LAI-ART were younger (U=20260.00, z=-
2,602, p < .05) and with higher education (X2 = 18,816, df =1, p=.000). Among
Injections seem safe 14.2%

PLWH who preferred LAI-ART, it was observed that those who use drugs were Convenience of pills 60.3%

more likely to choose one injectable every 6 months (X2 = 4,144, df =, p<.05). Safety and efficacy of pills 35.3%

The most common reasons to choose injectable (Figure 1) over pills were “The Injections produce discomfort and pain 19.2%

discomfort of having to take pills every day” (52.8%) and “I think it would improve
my quality of life” (40.3%).
Do not like needles 14.8%

Fear of injections 8.8%

Among HIV-negative individuals (Table 1), 53.3% had heard of PrEP before. Only 0% 10% 20% 30% 40% 50% 60% 70%

39.4% reported that they always used condoms. Regarding the route of PrEP
administration, 68% preferred injectable (15.8% of them every two months and
84.2% every 6 months), 23.3% one pill per week and 8.7% one pill per day. Figure 2. Reasons to choose injectable or pills for PrEP
Preference of injectable PrEP was similar in all gender/sexual orientation
groups:72.7% HM, 70.5% LBQ, 68.4% HW, 65.9% TNB and 65.6% GBQ. I'm afraid of forgetting a pill 57.9%

Injectable preference for PrEP was positively associated with having had a good Convenience 55.5%

experience using injectable medication before (Z = 3,4; p < .05). Common I don't want to take a pill every day 51.1%

reasons for choosing LAI PrEP were not wanting to take pills every day and fear Injections seem safe to me 23.8%

of forgetting them (Figure 2). Injections are a better way to give medicine

Unwanted effects of pills are greater than of injections 17.4%

Previous injections with any discomfort 15.2%

CONCLUSIONS Convenience of pills 76.2%

Overall, acceptance of LAI was high for both potential PrEP users and PLHIV I don't like injections 29.9%

based on its convenience, particularly among those with previous experience with I don't like needles 15.7%

LAI. Still more information is needed related to its implementation in our context Safety and efficacy of pills 9.6%

and the perspective of decision makers and health care providers. Fear of injections 8.6%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

ACKNOWLEDGMENTS
To all the participants of this study

Corresponding author: Virginia Zalazar virginia.zalazar@huesped.org.ar

www.huesped.org.ar