Navigating Long-Acting HIV Treatment: A Promising Path Forward

In 2022, the British HIV Association (BHIVA) revised its guidelines for HIV treatment, now recommending Long-acting injectable antiretroviral therapy (LA ART) as a viable option for individuals living with HIV.1

Linda Panton, a Charge Nurse and current Chair of the National HIV Nurses Association (NHIVNA), presented at the Chiva Conference in March on the practical implications of this recommendation at her clinic in Scotland. With the introduction of LA ART, eligible patients stand to benefit from improved adherence owing to reduced pill burden, extended dosing intervals, and potentially enhanced viral suppression.

Moreover, LA ART promises a newfound sense of privacy and reduced stigma associated with daily HIV medication. Nevertheless, Linda also underscored the challenges that accompany this novel approach, including:

  • possible injection site reactions
  • limited formulation choices
  • healthcare infrastructure demands
  • cost concerns, and access barriers.

Concerns about the persistence of drug levels, potential interactions with other medications, individual patient preferences and the lack of evidence in supporting key populations (e.g. people experiencing homelessness, substance misuse, mental health issues and prisoners) further complicate the landscape.

As healthcare providers navigate these complexities, striking a delicate balance between benefits and challenges will be imperative to fully leverage the potential of injectable ART in the fight against HIV transmission and progression.

As the session progressed, attendees were treated to a first-hand account from a young person living with HIV, who shared their personal experiences with LA ART. The interview, conducted by Sara Ayres, a Clinic Nurse Practitioner in HIV Medicine at Imperial College Healthcare NHS Trust, offered invaluable real-life insights into the daily realities of managing HIV with this innovative treatment approach.

With candid honesty, the young person provided a glimpse into their journey, shedding light on the practicalities, challenges, and triumphs encountered while on LA ART. Their testimony served as a poignant reminder of the profound impact that advancements in HIV care can have on the lives of those affected, while also highlighting the importance of ongoing dialogue and support within the healthcare community.

The integration of patient perspectives added invaluable insights into the lived experiences and challenges associated with LA ART. Beyond the clinical efficacy of the treatment, considerations of pain management, psychological well-being, and quality of life emerge as pivotal aspects of holistic HIV care. The young person’s account served as a reminder of the human voice in underlying medical innovations, highlighting the importance of patient-centred approaches and empathetic healthcare. 

In moving forward, it becomes imperative to engage in these necessary ongoing dialogues into addressing barriers and enhancing the accessibility and effectiveness of this treatment. By fostering a supportive and inclusive environment, as shown in the discussion between Sara and her patient, we can harness the potential of LA ART into the broader strategy to combat HIV transmission and improve the quality of life for individuals living with HIV.

1. British HIV Association. BHIVA guidelines on antiretroviral treatment for adults living with HIV-1 2022 2023 interim update. [Accessed Mar 15, 2024].