Home›Infectious Disease› 70% of adults with HIV willing to switch to long-acting antiretroviral regimens, meta-analysis finds
70% of adults with HIV willing to switch to long-acting antiretroviral regimens, meta-analysis findsMost People with HIV Are Willing to Switch to Long-Acting Therapy
AIDS (London, England)Published October 3, 2026Study authors: Mendes de Leon Kyra F, Klungers Roos D, Nieuwkerk Pythia T, Van Der Valk MarcPubMed ↗DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Interpret willingness to switch to long-acting ART cautiously given high heterogeneity.
This meta-analysis examined willingness among adults with HIV using daily oral antiretroviral therapy to switch to long-acting regimens. The authors pooled data on the proportion willing to switch to any long-acting regimen and to specific formulations.
Pooled willingness to switch to any long-acting regimen was 70% (95% CI: 59-79). For two-monthly intramuscular injections, pooled willingness was 60% (95% CI: 42-76).
The authors report high heterogeneity (I2 = 97.9% for any long-acting regimen; I2 = 97.5% for two-monthly injections), indicating that willingness varies substantially across settings and populations. They also note limited studies for alternative long-acting formulations such as tablets, implants, and intravenous infusions, and underrepresentation of low and middle-income countries.
Safety outcomes, follow-up duration, and funding or conflicts of interest were not reported. The authors state that understanding preferences for long-acting regimens is essential to guide policy and implementation, but the high heterogeneity suggests that preferences are highly context dependent and should be interpreted cautiously.
How this fits prior evidence
This meta-analysis extends prior coverage of antiretroviral therapy adherence, where good adherence was associated with a 6.30 odds ratio for viral load suppression, by quantifying willingness to switch to long-acting regimens. It also complements prior coverage of behavioral interventions that improve adherence and viral suppression, suggesting that long-acting options may address preference-related barriers. However, the high heterogeneity and underrepresentation of low and middle-income countries contrast with the more consistent adherence association previously reported, and no safety data are available to compare with prior evidence.
Researchers looked at the preferences of adults living with HIV who currently take daily oral antiretroviral therapy. The goal was to see if patients would be willing to switch to long-acting regimens, which are administered less frequently than daily pills.
The findings show that 70% of participants were willing to switch to any long-acting regimen. Specifically, 60% of those surveyed expressed a willingness to switch to intramuscular injections given every two months. These results suggest that many patients are interested in moving away from daily pill schedules.
It is important to note that these results come from a meta-analysis with high variability, meaning preferences may change based on a person's specific situation. There was also limited data on other types of long-acting options like implants or tablets. Talk with a healthcare provider to discuss which treatment options best fit your personal needs and lifestyle.
What this means for you:
Most people on daily HIV medication are open to switching to long-acting options, including two-monthly injections.
Common questions
What percentage of people with HIV are willing to switch to long-acting therapy?
The study found that 70% of adults currently taking daily oral antiretroviral therapy were willing to switch to any long-acting regimen. This suggests a high level of interest among patients in moving away from daily pill schedules toward less frequent treatment options.
Are people willing to use injections every two months for HIV treatment?
Yes, the data shows that 60% of the people studied were willing to switch to intramuscular injections given every two months. This specific long-acting option is one of the primary ways patients might reduce the frequency of their medication.
Is long-acting therapy available in many different forms?
While the study highlights interest in injections, there was limited data regarding other forms of long-acting treatment, such as tablets, implants, and intravenous infusions. Because preferences can vary based on individual circumstances, you should talk to your doctor about the specific options available to you.
OBJECTIVES: Long-acting regimens (LARs) offer promising alternatives for people with HIV, enhancing autonomy and convenience. Understanding preferences for LAR is essential to guide policy and implementation.
DESIGN: This systematic review and meta-analysis examined willingness among adults with HIV to switch from daily oral antiretroviral therapy (ART) to LAR.
METHODS: Following PRISMA guidelines, we included studies of adults with HIV using daily oral ART reporting willingness to switch to existing or hypothetical LAR. The primary outcome was the proportion willing to switch. Articles were searched in PubMed and Embase up to October 2024. Risk of bias was assessed using the RoB-PrevMH tool. A random-effects meta-analysis with a generalized linear mixed model synthesized willingness for LAR. Subgroup analyses explored heterogeneity. Alternative LAR were summarized descriptively.
RESULTS: Searches identified 2038 records, of which 22 studies were included. Most studies were conducted in Europe or North America (96%). Willingness to switch to any LAR was 70% [95% confidence interval (95% CI): 59-79; I2 = 97.9%]. Furthermore, two-monthly intramuscular injections were the most frequently investigated LAR, with a pooled willingness of 60% (95%CI: 42-76; I2 = 97.5%). No study-level characteristics explained heterogeneity. Limited studies investigated willingness for alternative LAR.
CONCLUSION: The majority of people with HIV expressed willingness to switch to LAR, with two-monthly intramuscular injections being the most commonly investigated formulation. Substantial heterogeneity persisted, suggesting that LAR preferences are highly context dependent. Evidence on alternative LAR, including tablets, implants and intravenous infusions, is limited. Low and middle-income countries were underrepresented, highlighting the need for geographically diverse research to better understand context-specific preferences and thereby inform treatment policy.
