The Promise of Improved Adherence With Long-Acting Antiretroviral Therapy: What Are the Data?

Kimberly K Scarsi, Susan Swindells, Kimberly K Scarsi, Susan Swindells

Abstract

As with other chronic conditions, adherence to daily medications remains a challenge for many individuals living with HIV due to structural, behavioral, and social barriers. Unfortunately, high levels of adherence to antiretroviral therapy are required to maintain virologic suppression. Alternative approaches are being explored to decrease the burden of daily pill administration, including long-acting injectable, oral, and implantable products. Phase 3 data support the efficacy of nanoformulated injectable cabotegravir and rilpivirine for HIV treatment in patients with undetectable viremia, but we have yet to learn how this strategy may benefit those with medication adherence challenges. Despite this, the affected community and HIV providers are very interested in exploring the role of long-acting therapies to address some types of barriers to medication adherence. This review summarizes available information about the potential for long-acting therapy to improve adherence for some patients and outlines associated opportunities and challenges with the implementation of long-acting therapy for the treatment and prevention of HIV.

Keywords: HIV; adherence; antiretroviral therapy; cabotegravir; long-acting; rilpivirine.

Conflict of interest statement

Declaration of Conflicting Interests: SS reports support for clinical trials to her institution from ViiV healthcare.

Figures

Figure 1.
Figure 1.
Long-acting antiretroviral therapy: potential opportunities and challenges.
Figure 2.
Figure 2.
Concerns regarding long-acting injectable antiretroviral therapy. Among 371 participants who indicated if they were willing to try LA ART, differences were found in the frequency of concerns identified between those willing and unwilling to receive LA ART. Adapted from Dandachi et al. AIDS Care 2020.

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