Home Administration of Long-Acting HIV Therapy is Safe, Effective
The investigators of a study also found that patient satisfaction with long-acting injectable antiretroviral therapy was equally as high when comparing home and clinic administration.
Home administration of a long-acting injectable antiretroviral therapy (ART) for patients with HIV is as safe and effective as when administered by a health care professional. The investigators of a study by the Medical University of South Carolina also found that patient satisfaction was equally as high compared to the 2 settings.1
The investigators of a study also found that patient satisfaction with long-acting injectable antiretroviral therapy was equally as high when comparing home and clinic administration. | Image Credit: jarun011 - stock.adobe.com
“This project was designed at the time that injectable treatment for HIV infection received approval, and so we were inspired to try to think of new ways for the persons we care for to be able to access it,” Eric Meissner, MD, PhD, an associate professor in the College of Medicine, said in a news release.1 “For some people who struggle with daily pill medications for HIV, there have been studies showing that the injectable treatment does improve adherence and clinical outcomes.”
According to the American Hospital Association, approximately 3.6 million people in the United States do not receive needed medical care due to transportation issues, which is a known social determinant of health. Transportation issues can include lack of vehicle access, inadequate infrastructure, long distances, lengthy time to reach services, and cost. This can affect a person’s health care outcomes and increase health costs.2
In the study published in Clinical Infectious Diseases, travel can impact ART for patients with HIV. Allowing patients access to medication in their own home and administered by a health care provider could potentially bridge the gap between travel and health care. Patients prescribed injectable cabotegravir plus rilpivirine (CAB/RPV) at the Infectious Diseases clinic at the Medical University of South Carolina were enrolled in a nonrandomized, observational study between August 2021 and December 2022, according to the study investigators.3
Thirty-three patients, who were 64% Black and 73% male, had a median age of 46 years. Three patients discontinued CAB/RPV and received oral ART due to allergy, loss of virologic suppression, and visit adherence. There were 18 patients who received treatment in a clinic and 15 who received treatment at home. Despite being offered a choice, most individuals continued their original treatment choice. Patients completed 12 months of treatment.1,3
The investigators coordinated care with pharmacies, which mailed the medication to patients. Patients stored the medication in the refrigerator until visited by their licensed practical nurse, who administered the medication, and oftentimes, the same nurse administered ART to the same patients, which contributed to high satisfaction due to continuity of care.1
Approximately 52% of infections caused injection site pain or soreness and did not differ between the groups. Furthermore, investigators found no differences in safety or efficacy, and both groups had high treatment satisfaction. All patients were virologically suppressed and continued care at the conclusion of the study.3
“Convenience was far and away the most commonly stated reason driving the preference for where to receive treatment,” Meissner said.1 “I think that relates to the fact that a significant percentage of our cohort doesn’t live right next to our clinic. Many may have difficulty with the time and the logistics of transportation required to come to our downtown clinic.”
Despite the satisfaction with at-home administration, providing medication by mail and scheduling a nurse visit needed coordination by staff, and insurance does not currently reimburse for additional steps, making it unlikely for providers to offer this option.1
READ MORE: HIV Resource Center
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