Long-acting antiretroviral injections: perspectives of people living with HIV in three Middle East countries.

BACKGROUND

Although daily oral antiretroviral therapy (ART) is effective, pill burden, adherence challenges, stigma, and confidentiality concerns remain problematic for people living with HIV (PLHIV). Long-acting injectable ART (LAI-ART) is a promising alternative; however, data from the Middle East and North Africa (MENA) are limited. This study assessed PLHIV interest in LAI-ART and explored perceived benefits and barriers to implementation.

METHODS

A multicenter cross-sectional survey was conducted from October 2023 to December 2024 among PLHIV in Egypt, the Kingdom of Saudi Arabia, and Oman who were receiving or had previously received ART.

RESULTS

Among 1010 respondents, 88.7% expressed an interest in LAI-ART. Reported benefits included avoiding daily pills (91.1%), improved adherence (87.8%), enhanced confidentiality (86.7%), support for treatment adherence with comorbidities (88.3%), and reduced missed doses (74.5%). Reported barriers included injection pain (31.9%), difficulty scheduling travel within injection windows (30.6%), and frequent clinic visits (23.3%) to receive the injection.

CONCLUSION

High interest in LAI-ART suggests readiness for adoption in the MENA region. Successful implementation requires addressing injection-related concerns through patient education, ensuring trained healthcare personnel, and adopting flexible scheduling to accommodate travel and lifestyle needs, while leveraging confidentiality benefits to mitigate HIV-related stigma and support adherence.