Long-acting injectable HIV treatment is attractive to many people living with HIV, but a new Rutgers Health-led survey shows that real-world use remains far behind patient interest.
The study surveyed 801 people living with HIV in Boston, Chapel Hill, North Carolina, and San Diego. More than two thirds of participants said they would prefer antiretroviral injections every two months instead of taking a daily pill. Despite that preference, only a small share of patients in the study were receiving injectable therapy, even though the regimen has been available for several years.
The gap matters because injectable treatment may solve practical problems that daily medication can create. Some patients describe pill fatigue, missed doses, privacy concerns, or fear that a pill bottle could disclose their diagnosis. Long-acting therapy can reduce those burdens, but it requires reliable clinic visits and systems that make the injections accessible.
Researchers found that people who felt a higher daily pill burden were more likely to prefer injections. Patients with detectable viral loads also showed interest in monthly injections, although clinicians may hesitate to offer a regimen that depends on regular office appointments when adherence is already difficult. The study also found stronger interest among Black participants, a signal that access and stigma should be addressed directly in treatment conversations.
Older adults, people with needle fear, and patients who lived far from a clinic were less likely to prefer injections. The findings point to a practical clinical message: HIV treatment choices should be discussed with each patient rather than assumed. As newer long-acting options are studied, structured conversations may help match treatment to the patient’s life and improve viral suppression.