"It made me more confident that I have it under control": patient and provider perspectives on moving to a two-drug ART regimen in the United States and Spain

Davis, Wendy; Mantsios, Andrea; Karver, Tahilin; Murray, Miranda; Punekar, Yogesh; Ward, Douglas; Bredeek, U. Fritz; Moreno, Santiago; Merino, Dolores; Knobel Freud, Hernando; Campis, Antonio; Kerrigan, Deanna

"It made me more confident that I have it under control": patient and provider perspectives on moving to a two-drug ART regimen in the United States and Spain

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dc.contributor.author Davis, Wendy
dc.contributor.author Mantsios, Andrea
dc.contributor.author Karver, Tahilin
dc.contributor.author Murray, Miranda
dc.contributor.author Punekar, Yogesh
dc.contributor.author Ward, Douglas
dc.contributor.author Bredeek, U. Fritz
dc.contributor.author Moreno, Santiago
dc.contributor.author Merino, Dolores
dc.contributor.author Knobel Freud, Hernando
dc.contributor.author Campis, Antonio
dc.contributor.author Kerrigan, Deanna
dc.date.accessioned 2020-10-28T07:44:34Z
dc.date.available 2020-10-28T07:44:34Z
dc.date.issued 2020
dc.description.abstract Background: Two-drug regimens (2DR) to treat HIV infection have the potential to reduce long-term toxicity and increase therapeutic options for people living with HIV (PLHIV). Prior phase III trials, SWORD-1 and SWORD-2, as well as GEMINI-1 and GEMINI-2, have demonstrated that a dolutegravir-based 2DR is as effective as three- or four-drug regimens among virologically suppressed patients. Limited information exists, however, on patient and provider experiences with 2DR to inform roll-out and integration into routine clinical care. Methods: We conducted 39 in-depth interviews with PLHIV currently on 2DR in the context of routine care and 8 of their clinical care providers in the United States (U.S.) and Spain. Participants included 33 male and 6 female PLHIV and 8 providers. Interview topics explored perceptions of and experiences with 2DR compared to prior anti-retroviral regimens (ARVs), side effects, patient satisfaction, and clinical performance. Interviews were audio-recorded, transcribed and analyzed using thematic content analysis. Results: Participants viewed 2DR as a significant and positive advance, in terms of its ability to effectively treat HIV with reduced toxicity and essentially no reported side effects. Patients noted the central role providers played in the decision to switch to a 2DR regimen and, among U.S. participants, the importance of insurance coverage making this preferred option feasible. Patients and providers agreed that a 2DR regimen would be appropriate for any PLHIV regardless of whether they were treatment naïve or had significant experience with ARVs. Conclusions: Participants' experiences with a 2DR regimen were positive with no participants, reporting side effects and all reporting continued viral suppression. Providers valued the reduced toxicity offered by 2DR and served as the primary gateway to a transition to 2DR for patients in both settings. This study provides a foundation for further research on the transition to 2DR regimens in other populations and contexts including low- and middle-income settings.
dc.format.mimetype application/pdf
dc.identifier.citation Davis W, Mantsios A, Karver T, Murray M, Punekar Y, Ward D. et al. "It made me more confident that I have it under control": patient and provider perspectives on moving to a two-drug ART regimen in the United States and Spain. PLoS One. 2020 May 1; 15(5):e0232473. DOI: 10.1371/journal.pone.0232473
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0232473
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10230/45596
dc.language.iso eng
dc.publisher Public Library of Science (PLoS)
dc.rights Copyright © 2020 Davis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.other VIH (Virus) -- Tractament
dc.subject.other Persones seropositives
dc.title "It made me more confident that I have it under control": patient and provider perspectives on moving to a two-drug ART regimen in the United States and Spain
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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