A small study of women living with HIV found that a majority said they would prefer to receive monthly injectable antiretroviral (ARV) treatment over a daily pill regimen.

Canada recently became the first nation to approve ViiV Healthcare’s long-acting injectable regimen Cabenuva (cabotegravir/rilpivirine), which is provided as a shot into the muscle by a health care provider once a month.

In December, the U.S. Food and Drug Administration (FDA) declined to approve Cabenuva, citing concerns over its manufacturing. ViiV has indicated that it is working with the FDA to address those concerns.

Researchers at Columbia University’s Mailman School of Public Health conducted a qualitative study of 59 HIV-positive women who participated in the Women’s Interagency HIV Study, the largest national study of women living with and at risk for the virus. The women lived in New York, Chicago, Washington, DC, Atlanta, Chapel Hill, North Carolina, and San Francisco and were interviewed between November 2017 and October 2018.

As described in the Journal of Acquired Immune Deficiency Syndromes, 56% of the women said they would prefer to receive monthly injectable HIV treatment rather than daily pills. The top reasons they gave for this preference were convenience and confidentiality, avoiding daily reminders about having HIV, and believing that injectable treatment was more effective. Thirty-four percent of the women said they would prefer daily oral pills, and 10% would prefer neither pills nor injectable treatment.

The study authors identified existing barriers to providing women with long-acting injectable treatment, including women’s mistrust of the medical system, concerns about safety and effectiveness, and barriers to making additional medical visits.

“Adherence to antiretroviral therapy is imperative for viral suppression and reducing HIV transmission, but many people living with HIV report difficultly sustaining long-term adherence over the life span,” Morgan Philbin, PhD, the study’s lead authors and an assistant professor of sociomedical sciences at Columbia University’s Mailman School of Public Health, said in a press release. “We found that long acting injectable antiretroviral therapy was a compelling option among the women we interviewed.”

Philbin continued, saying “women also described challenges unique to them as women that would need to be addressed in order to ensure that they fully benefit from these new technologies, including the role of children and childbearing, caregiving responsibilities and long histories of medical mistrust. As a result, we want to highlight the need to incorporate women into the process of [long-acting injectable antiretroviral treatment] roll out to ensure their inclusion.”

To read the study abstract, click here.