CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

regarding perceptions of the future prospect of receiving ART in the community setting (at M6) did not improve from baseline. 96% preferred injectable to oral ART at M4. At M4, IAM mean scores were significantly less favourable in Black participants than in White participants with respect to the injection (4.44 vs. 4.67; p=0.029) and the community setting (3 vs 3.75;p=0.003). Conclusion: Over four months, participants found injections increasingly feasible, appropriate and satisfactory, and preferred them to oral ART. Pre specified sub-group analyses based on gender and race and ethnicity revealed significant differences around perception of delivering LA ART in the community in Black participants. These findings will be further evaluated in relation to psychological challenges.

middle-income countries. PrEP studies evaluated CAB 8 (57%), rilpivirine (RPV) 2(14%) and mono-clonal antibodies 4 (29%). Treatment studies evaluated CAB+RPV, lenacapavir, albuvirtide and monoclonal antibodies, [18 (67%), 5 (18%), 3 (11%), 1 (4%), respectively]. The number of female participants increased 98-fold in PrEP studies (2014-present), and 361-fold in treatment studies (2010-present). However, the percentage of female participants in LA-I treatment studies during 2022/3 remains disappointing [724/3709 (19%)]. From 2020, gender-targeted PrEP studies were established to ensure inclusive recruitment. Between 2019-2023, 42% of participants in PrEP studies were female (n=5390). Only 13/41 (32%) studies reported on self-identified gender. The number and proportion of transgender women, transgender men, and NBP included in treatment and PrEP studies was 728 (4%), 28 (0.2%) and 58 (0.3%), respectively. Conclusion: The number of female participants in studies on LA-I treatment have significantly increased, but remain unacceptably low at 19% (2022/3) and do not reflect the global population. Gender-targeted PrEP studies have been effective at increasing numbers of females recruited. Transgender and NBP remain very poorly represented. A gender-targeted approach to inclusion in treatment studies is urgently needed and long overdue.

Poster Abstracts

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Acceptability of Long-Acting Cabotegravir & Rilpivirine in a Large Urban Ambulatory HIV Clinic Casey M Luc 1 , Blake Max 1 , Sarah Perez 2 , Kara Herrera 1 , Mark Dworkin 1 1 University of Illinois at Chicago, Chicago, IL, USA, 2 Ruth M Rothstein CORE Center, Chicago, IL, USA Background: There are limited data regarding the acceptability of injectable long-acting cabotegravir and rilpivirine (LA-CAB/RPV) outside of randomized controlled trials (RCTs). We performed a mixed-methods analysis to describe patient-reported outcomes (PROs) of LA-CAB/RPV among a population often underrepresented in RCTs at one of the largest HIV/AIDS care centers in the United States. Methods: We interviewed persons living with HIV (PLWH) who received at least one dose of LA-CAB/RPV at the Ruth M. Rothstein CORE Center in Chicago, Illinois. PRO endpoints included mean treatment satisfaction (1 [Very Unsatisfied] to 7 [Very Satisfied]), mean tolerability of injection site pain (1 [Not at All Bothered] to 10 [Very Bothered]), and reasons for switching to LA-CAB/ RPV. Mean and standard deviations (mean±SD) and proportions (%) are reported. Results: Among the respondents (N=136), 68.4% identified as Black/African American, 24.3% as Hispanic, 36.0% as female, 58.1% as male; the median age was 43 years (range 21-76), with 36.8% being ≥50 years old. Most respondents (92.6%) completed ≥3 injection appointments at the time of interview. The two most common reasons for switching from oral therapy to LA-CAB/RPV were no longer wanting to take pills (89.7%) and had trouble taking their pills daily (58.8%). Treatment satisfaction was high (6.7±0.4). Two-thirds (64.0%) reported an aspect of their life improved that was not expected after initiation. The majority (90.4%) reported pain from injections, with a mean pain level of 4.2±2.7. Among those reporting pain, half (48.8%) reported pain decreased after initial injection. Among those with a reported >6 level of pain (N=31), most (83.9%) reported no improvement since initial injection. One-fifth (19.1%) reported swelling from injections and one-third (33.1%) reported anxiety before injections. Conclusion: We found high treatment satisfaction with LA-CAB/RPV in a population with a high proportion of people of color, women, and PLWH ≥50 years old. Patients reported moderate pain with injections, which improved with time. These results suggest that scaling up of injectable LA-CAB/RPV will be met with high patient acceptability across diverse patient populations.

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Implementing LA Cabotegravir (CAB)+Rilpivirine (RPV) Therapy in 6 UK Clinics & in the Community: ILANA Chloe M Orkin 1 , Joanne S. Haviland 1 , Yuk L. Wong 1 , Sara Paparini 1 , Bakita Kasadha 2 , Rosalie Hayes 1 , Julie Fox 3 , Ruth Byrne 4 , Amanda Clarke 5 , Emily Clarke 6 , Tristan J. Barber 7 , Vanessa Apea 1 , for the ILANA Study Group 1 Queen Mary University of London, London, United Kingdom, 2 University of Oxford, Oxford, United Kingdom, 3 King's College London, London, United Kingdom, 4 Chelsea and Westminster NHS Foundation Trust, London, United Kingdom, 5 Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom, 6 Royal Liverpool University Hospital, Liverpool, United Kingdom, 7 Royal Free Hospital, London, United Kingdom Background: The feasibility of implementing CAB+RPV LA ART in the community has not yet been described. In the first UK-based study, we purposefully recruited participants more representative of the global population of PLWH to evaluate feasibility of implementation in 6 clinics (in & outside London) and in the community. Methods: ILANA is a 1-year UK-based implementation study in PLWH who switched to CAB+RPV LA 2-monthly within the label. Participants receive CAB+RPV in the clinic for 6 months with an option to receive the drug in the clinic or community (eg home or community organization) from M6-M12. This prespecified M4 analysis evaluated PLWH perspectives on feasibility and acceptability of CAB+RPV LA and on potential community delivery through validated implementation questionnaires [Feasibility of Intervention Measure (FIM), Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), HIV Treatment Satisfaction Questionnaire (HIVTSQ-12)] at baseline and 4 months. Results: Between May-December 2022 we enrolled 114 virally suppressed PLWH [53% female, 51% Black, 30% White, 40%> 50yrs, 68% heterosexual,75% employed]. Median time since diagnosis was 13 yrs (IQR 8, 19), time on ART was 11 yrs (IQR 7,16) with a mean of 3 prior regimens. 57% had received NNRTIs. 84% had other co-morbidities, and 80% (91/114) were taking non-ART medications. 75% (68/91) were on >2 non-ART drugs. 99% of injections were given within the 7-day window. There were 5 discontinuations by M4 (2 injection-related, 3 participant choice). 1 participant with VL 478 at M4 continued. Regarding injectable treatment: FIM, IAM and HIVTSQ scores improved significantly (baseline to M4) (Table). FIM, IAM and AIM scores

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