Daily oral antiretroviral therapy (ART) remains effective for viral suppression in people living with HIV (PLHIV), but regimen-related challenges persist. The abstract identifies ongoing issues such as pill burden, adherence difficulties, and concerns about stigma and confidentiality that can reduce treatment acceptability and continuity. As an alternative, long-acting injectable antiretroviral therapy (LAI-ART)—notably formulations involving agents such as cabotegravir and rilpivirine—has emerged as a promising option to address these barriers. Data from the Middle East and North Africa (MENA) region have been limited, prompting the study summarized here to assess PLHIV perspectives in three Middle Eastern countries.
The study was a multicenter cross-sectional survey conducted between October 2023 and December 2024. Respondents were people living with HIV in Egypt, the Kingdom of Saudi Arabia (KSA) and Oman. Inclusion criteria reported in the abstract were PLHIV who were receiving or had previously received ART. The total sample comprised 1,010 respondents. The abstract does not provide further methodological details such as sampling methods, respondent demographics, recruitment sites, or analytic procedures; these would need to be confirmed from the full text.
The primary outcome reported in the abstract was expressed interest in LAI-ART among the surveyed PLHIV population. A large majority—88.7% of respondents—expressed interest in LAI-ART. This high level of interest is presented by the authors as an indicator of readiness among PLHIV in the MENA region for adoption of injectable long-acting antiretroviral options.
Survey respondents identified several potential benefits they associated with LAI-ART. These included:
Avoiding daily oral pills (reported by 91.1% of respondents), which addresses the burden of daily dosing.
Improved adherence (reported by 87.8%), suggesting respondents believe injections could support more consistent treatment use.
Enhanced confidentiality (reported by 86.7%), reflecting the potential for injections to reduce disclosure risks tied to pill-taking.
Support for adherence in the context of comorbidities (reported by 88.3%), indicating respondents saw LAI-ART as compatible with management of additional health conditions.
Reduced missed doses (reported by 74.5%), highlighting a perceived practical advantage in maintaining therapeutic coverage.
These reported benefits align with the rationale for LAI-ART as a strategy to mitigate daily pill-related barriers and stigma-related challenges.
Respondents also reported concerns that could hinder uptake or satisfaction with LAI-ART. Key barriers identified in the abstract include:
Injection-related pain (31.9%): pain at the injection site or discomfort associated with intramuscular administration was a commonly noted concern.
Difficulty scheduling travel within allowable injection windows (30.6%): respondents anticipated logistic challenges when travel or mobility might conflict with the timing required for repeat injections.
Frequent clinic visits required to receive injections (23.3%): the need for regular clinic attendance was perceived as a potential burden, in contrast to self-administered oral therapy.
These barriers suggest that practical delivery considerations and patient experience with injections will influence successful implementation.
Based on survey findings, the authors emphasize several priorities for implementation if LAI-ART is to be adopted in the region. These include:
Addressing injection-related concerns through targeted patient education to set expectations about injection pain, side-effect profiles, and management strategies.
Ensuring availability of trained healthcare personnel who can administer injections safely and manage adverse events.
Adopting flexible scheduling and service delivery approaches to accommodate travel, work and lifestyle needs, and to reduce the barrier posed by clinic visit frequency.
Leveraging the confidentiality advantages of LAI-ART to help mitigate HIV-related stigma and to support adherence efforts.
The abstract frames these measures as necessary components to translate high patient interest into sustained, equitable access and successful real-world implementation.
In summary, this multicenter survey of 1,010 PLHIV across Egypt, Saudi Arabia and Oman found strong interest in LAI-ART (88.7%) and identified both clear perceived benefits—such as avoiding daily pills, improved adherence and enhanced confidentiality—and tangible barriers related to injections, scheduling and clinic visits. The authors conclude that the MENA region appears ready for adoption of LAI-ART but that successful implementation will require attention to patient education, workforce training and adaptable service models. The abstract lists keywords that include HIV, Middle East, antiretroviral therapy, cabotegravir, long-acting injectable and rilpivirine.
Note: the abstract provides core results and high-level recommendations; additional study details (demographics, sampling methods, statistical analyses, and limitations) were not reported in the abstract and would require consultation of the full article for comprehensive appraisal.