“The injection gives freedom” - An exploration of long-acting injectable HIV treatment acceptance among patients seeking care in two Nairobi tertiary hospitals
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Background
Long-acting injectable antiretroviral therapy offers an alternative to daily oral HIV treatment, potentially improving adherence and reducing stigma. While its adoption has been successful in some settings, little is known about its acceptability among people living with HIV in Kenya. This study evaluates the acceptability, barriers, and facilitators of long-acting injectable antiretroviral therapy among people living with HIV in Nairobi, Kenya.
Methods
We conducted a mixed-methods study involving 356 people living with HIV receiving care at Kenyatta National Hospital and Aga Khan University Hospital. Quantitative data were collected through structured surveys, while qualitative insights were obtained from three focus group discussions. Descriptive and inferential statistical analyses were performed on survey data, and thematic analysis was applied to focus group discussions transcripts.
Results
Overall, 72.2% of participants expressed willingness to switch to long-acting injectable antiretroviral therapy Interest in long-acting injectable antiretroviral therapy was significantly associated with prior knowledge (93.9% vs 80.2%, p < 0.001) and more likely among women ((93.5% vs. 83.9%, p = 0.009). Key facilitators included the opportunity to stop taking daily pills (71.3%), improved adherence (50.3%) and reduced daily focus on HIV (44.7%). The most frequently cited barriers were fear of side effects (69.7%), needle phobia (32.3%), and distrust in new treatments (20.2%). focus group discussions revealed interest about long-acting injectable antiretroviral therapy’s potential to reduce stigma and improve adherence, but also concerns about side effects, access, and the need for robust support systems.
Conclusion
People living with HIV in the participating hospitals in Nairobi showed strong interest in long-acting injectable antiretroviral therapy, driven by its potential to improve adherence and reduce stigma. However, concerns about side effects, injections, and access must be addressed. Targeted education, provider training, and healthcare support are crucial for successful implementation.
