Abstract
Background
While long-acting injectables (LAIs) offer alternatives to daily oral regimens by improving adherence and reducing stigma, patient perspectives – especially in low-income settings – remain underexplored. This qualitative study explores people living with (PWH) and without HIV (PWoH)’s experiences with LAI HIV medications for treatment (LAI-ART) and prevention (LAI-PrEP) in a safety-net hospital, which provides care regardless of insurance status or ability to pay.
Methods
Participants were recruited using a convenience sampling approach; patients who presented for routine care or injection visits at the clinic who had been taking LAI-PrEP or LAI-ART for more than two months were offered participation. In depth one-on-one semi-structured interviews were conducted with 30 patients (ages 25–66) between May and November of 2024, including both LAI-ART and LAI-PrEP users. Thematic analysis (TA) guided by Braun and Clarke’s six-step framework was applied to analyze the data collected.
Results
Twenty two out of 30 participants were on LAI-ART. Median age was 42; 73.3% identified as Black or African American, 96.6% as non-Hispanic, and 53.3% as male. The TA revealed key benefits: greater convenience, fewer daily reminders of HIV status, and improved emotional well-being. Participants also identified challenges, including injection site pain, side effects, inflexible appointment schedules, and reduced autonomy in care decisions. Trust in healthcare providers and effective communication were critical to uptake and ongoing use.
Conclusion
By amplifying voices of PWH and PWoH, this study reveals both the potentials and limitations of LAI HIV medications. Findings underscore the importance of patient-centered approaches and can inform implementation strategies and public health efforts aimed at improving adherence and health outcomes among vulnerable populations.
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Abbreviations
- FDA:
-
Food and Drug Administration
- HIV:
-
Human immunodeficiency virus
- LAI:
-
Long-acting injectable
- LAI-ART:
-
Long-acting injectable antiretroviral therapy
- LAI-PrEP:
-
Long-acting injectable pre-exposure prophylaxis
- PrEP:
-
Pre-exposure prophylaxis
- PWH:
-
People living with HIV
- PWoH:
-
People living without HIV
- STI:
-
Sexually transmitted infection
- TA:
-
Thematic analysis
Acknowledgements
We would like to acknowledge MetroHealth Medical Center for providing the clinical setting and support that made this study possible.
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This study was performed in line with the principles of the Declaration of Helsinki after obtaining approval from the Ethics Committee of MetroHealth Medical Center (IRB ID: STUDY00000540). All participants offered informed verbal consent to participate in the study.
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The authors declare no competing interests.
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Heath, M., Sudovec-Somogyi, J.V. & Avery, A. Experiences of people living with and without HIV with long-acting injectable HIV treatment and prevention in a safety-net hospital in Cleveland – a cross-sectional thematic analysis. BMC Infect Dis (2026). https://doi.org/10.1186/s12879-026-14151-3
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DOI: https://doi.org/10.1186/s12879-026-14151-3