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WHO WANTS TO SWITCH? GAUGING INTEREST IN POTENTIAL NEW ANTIRETROVIRAL THERAPIES
Jan Ostermann1, Caroline Derrick1, Amy Hobbie2, Andrew Weinhold2, Noor Al-Shareef1, Valerie Yelverton3, Sharon Weissman1, Helmut Albrecht1, Nathan Thielman2
1University of South Carolina at Columbia, Columbia, SC, USA,2Duke University, Durham, NC, USA,3Hochschule Neubrandenburg University of Applied Sciences, Neubrandenburg, Germany
Despite increased numbers of easily tolerated and highly effective antiretroviral regimens, adherence rates for many populations remain suboptimal. Novel drug delivery systems and drugs with extended half-lives may allow for dramatically reduced dosing frequency of specific antiretroviral regimens. To explore initial interest in such regimens, we gathered detailed treatment history and antiretroviral preference information from 263 treatment experienced patients.
Between February and August 2017, a convenience sample of 263 HIV-infected patients from Infectious Diseases clinics at Duke University and the University of South Carolina were surveyed about HIV treatment experiences and attitudes. Participants were asked about characteristics of their current regimen as well as their interest, on 5-point scales (1=not at all interested; 5=very interested), in switching to either a single pill once a week, two shots in clinic every other month, or implanting and removing two small plastic rods about the size of matchsticks in each forearm every six months. Multivariate linear regression methods identified correlates of patients' interest in switching to these alternatives from their current regimen.
Survey participants were highly experienced (mean 14.3 years on therapy), predominantly minority (80.5%), with a mean age of 46.7 years, and 41.4% had received more than high-school education. In multivariate analysis, clinic, gender, race/ethnicity, time on treatment, taking more than 1 pill a day, and administration restrictions, were not associated with interest in switching to novel regimens. Those who had previously switched regimens expressed greater interest in switching to a single pill once a week (p=.03); higher education was associated with greater interest in switching to injection and implants (p<.01), and younger age was associated with greater interest in switching to injection (p=.02).
Across a highly treatment-experienced cohort of HIV-infected patients, we describe greatest interest in switching to an oral regimen taken once weekly, followed by injections taken every other month. Those with higher education expressed greater interest in novel drug delivery systems and younger patients were more interested in injections. Having taken more prior regimens was associated with greater interest in a weekly oral pill. Understanding drivers of preference heterogeneity for new treatment modalities may help to inform their development and predict uptake.