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Adherence to daily oral antiretroviral therapy (ART) remains a significant challenge for many people living with HIV (PLHIV). While effective, daily pills often lead to pill fatigue and heighten concerns regarding privacy and social stigma. However, a recent multicenter study highlights a strong global interest in Long-acting injectable ART as a viable alternative. This research, conducted across Egypt, Saudi Arabia, and Oman, provides critical insights into patient readiness for this medical innovation.
The study, which surveyed 1,010 respondents, found that nearly 89% expressed a high interest in transitioning to injectable regimens. Participants identified several compelling benefits. For instance, 91.1% sought to avoid the daily burden of pills, which can be emotionally taxing. Furthermore, 87.8% believed that injections would significantly improve their treatment adherence. Most importantly, 86.7% highlighted enhanced confidentiality as a major advantage. By eliminating the need to store or carry medication, Long-acting injectable ART helps patients maintain privacy and avoid potential stigma.
Despite the overwhelming interest, certain implementation hurdles must be addressed. Approximately 31.9% of patients expressed concerns regarding injection site pain. Additionally, 30.6% noted difficulties in scheduling travel around injection windows. To ensure successful adoption, healthcare systems should provide flexible scheduling and robust patient education. Consequently, training healthcare personnel is essential to manage injections effectively and mitigate physical discomfort. Moreover, the World Health Organization (WHO) recently updated its guidelines in 2025 to support these injectable options for virally suppressed adults.
Integrating long-acting options into clinical practice requires a patient-centered approach. Providers should evaluate individual patient needs, focusing on those who struggle with adherence or confidentiality. By offering Long-acting injectable ART, clinicians can help patients achieve better long-term health outcomes. In conclusion, the high level of readiness among PLHIV suggests that this technology is not just a clinical advancement but a vital tool for improving quality of life.
Typically, these injections are recommended for adults who are already virally suppressed on a stable oral regimen. However, recent international guidelines are expanding these criteria to include those with specific adherence challenges.
The most common regimens currently approved involve injections every one or two months, depending on the specific medication and clinical assessment.
Most patients report minor injection site reactions, such as mild pain, swelling, or redness. These symptoms are generally temporary and tend to decrease over time with repeated doses.
Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.
References
Mohamed R et al. Long-acting antiretroviral injections: perspectives of people living with HIV in three Middle East countries. Trans R Soc Trop Med Hyg. 2026 May 21. doi: undefined. PMID: 42165185.
World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. 2025.
Overton ET, et al. Long-acting cabotegravir and rilpivirine for HIV-1 treatment. Lancet. 2020;396(10267):1994-2005.

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