In 2020, 14% of diagnosed persons living with HIV (PLWH) in Kenya were not taking antiretroviral therapy (ART), and 19% of those on ART had unsuppressed viral loads. Long-acting antiretroviral therapy (LA-ART) may increase viral suppression by promoting ART uptake and adherence. We conducted key informant (KI) interviews with HIV experts in Kenya to identify product and delivery attributes related to the acceptability and feasibility of providing LA-ART to PLWH in Kenya. Interviews were conducted via Zoom on potential LA-ART options including intra-muscular (IM) injections, subcutaneous (SC) injections, implants, and LA oral pills. KI were asked to discuss the products they were most and least excited about, as well as barriers and facilitators to LA-ART roll-out. In addition, they were asked about potential delivery locations for LA-ART products such as homes, pharmacies, and clinics. Interviews were recorded and transcribed, and data were analyzed using a combination of inductive and deductive coding. Twelve KI (5 women, 7 men) participated between December 2021 and February 2022. Overall, participants reported that LA-ART would be acceptable and preferable to PLWH because of fatigue with daily oral pills. They viewed IM injections and LA oral pills as the most exciting options to ease pill burden and improve adherence. KI felt that populations who could benefit most were adolescents in boarding schools and stigmatized populations such as sex workers. SC injections and implants were less favored, as they would require new training initiatives for patients or healthcare workers on administration. In addition, SC injections would require refrigeration and needle disposal after use. Some KI thought patients, especially men, might worry that IM injections and implants would impact fertility, given their role in family planning. Pharmacies were perceived by most KI as suboptimal delivery locations; however, given ongoing work in Kenya to include pharmacies in antiretroviral delivery, they recommended asking patients their views. There is interest and support for LA-ART in Kenya, especially IM injections and LA oral pills. Identifying patient preferences for modes and delivery locations and addressing misconceptions about specific products as they become available will be important before wide-scale implementation.

中文翻译：

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主要知情人对肯尼亚艾滋病毒长效抗逆转录病毒治疗的潜在可接受性和可行性的看法

2020 年，肯尼亚 14% 的确诊艾滋病毒感染者 (PLWH) 没有接受抗逆转录病毒治疗 (ART)，而接受 ART 的患者中有 19% 的病毒载量未受到抑制。长效抗逆转录病毒疗法 (LA-ART) 可能通过促进 ART 的吸收和依从性来增强病毒抑制。我们对肯尼亚的艾滋病毒专家进行了关键知情人 (KI) 访谈，以确定与向肯尼亚的感染者提供 LA-ART 的可接受性和可行性相关的产品和交付属性。通过 Zoom 对潜在的 LA-ART 选择进行了采访，包括肌内 (IM) 注射、皮下 (SC) 注射、植入物和 LA 口服药丸。 KI 被要求讨论他们最感兴趣和最不感兴趣的产品，以及 LA-ART 推出的障碍和促进因素。此外，他们还被问及 LA-ART 产品的潜在交付地点，例如家庭、药房和诊所。采访被记录和转录，并使用归纳和演绎编码的组合来分析数据。 2021 年 12 月至 2022 年 2 月期间，12 名 KI（5 名女性、7 名男性）参与了研究。总体而言，参与者报告说，由于每日口服药片会产生疲劳，LA-ART 比 PLWH 更可接受且更可取。他们认为肌内注射和洛杉矶口服药是减轻药物负担和提高依从性的最令人兴奋的选择。 KI 认为，最能受益的人群是寄宿学校的青少年和性工作者等受到污名化的人群。 SC 注射和植入不太受青睐，因为它们需要对患者或医护人员进行新的管理培训。此外，SC 注射需要冷藏并在使用后处理针头。一些 KI 认为，鉴于患者在计划生育中的作用，患者，尤其是男性，可能会担心肌内注射和植入会影响生育能力。大多数 KI 认为药房是次优的递送地点；然而，鉴于肯尼亚正在进行将药房纳入抗逆转录病毒治疗的工作，他们建议询问患者的意见。肯尼亚对 LA-ART 很感兴趣并支持，尤其是肌内注射和 LA 口服药。在大规模实施之前，确定患者对模式和交付地点的偏好并解决对特定产品的误解非常重要。