Acceptance and preference for Long-Acting Antiretrovirals among people living with HIV in China

Introduction: Long-acting Antiretroviral (LAARV) regimen was found as effective as standard daily oral antiretroviral therapy (ART) for maintaining HIV-1 suppression. China has one of the largest numbers of people living with HIV (PLHIV) and provides the national free ART with limited regimens, which does not include LAARV. The acceptability of LAARV among PLHIV in China was left unknown. Methods: During 1 June 2022 and 30 November 2022, we conducted an online survey of PLHIV in China on acceptance and preference of LAARV. The acceptance based on a five-point scale was dichotomized to more likely to use (i.e., very likely, likely) and less likely to use (i.e., very unlikely, unlikely, uncertain). Logistic regression was used to assess acceptance for LAARV and correlates. Results: 2570 PLHIV responded to the questionnaire and 67% were interested in LAARV. PLHIV currently using the single tablet regimen (STR) was the most potential user for LAARV (Adjust Odds Ratio [AOR] 1.68, 95% Confidence Interval [CI]: 1.32 to 2.15). Subjective assessment of less adherence to ART was correlated with more interest (AOR 1.63, 95% CI: 1.30 to 2.05). The preference for LAARV types from high to low was intramuscular injection (every 1-2 months), implants (every 6-12 months), and intravenous infusion (once every 1-2 weeks). Conclusions: Our study reported the acceptance, most potential users for LAARV among PLHIV in China, closing the knowledge gap that exists in the implementation of LAARV in China. A cost-competitive long-acting intramuscular injection ART is the LAARV with the most acceptability in China.