ArticleOpen forum infectious diseases2025
High Acceptability but Persistent Barriers to Implementation of Long-acting Injectable Antiretrovirals: A Nationwide Cross-sectional Survey of Ryan White Clinics in the United States.
Article in Open forum infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Accelerating Low-Barrier Use of Long-Acting Antiretroviral Therapy to Maximize Impact in People with HIV and Viremia or Adherence Challenges.Current HIV/AIDS reports · 2026Review
- Brief Report: Real-World Uptake and Clinical Outcomes of Long-Acting Injectable Cabotegravir/Rilpivirine in the United States, 2021-2023.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Facilitators and Barriers to Home-Based Long-Acting Injectable Antiretroviral Therapy: Clinician Perspectives from the INVITE-Home Study.AIDS and behavior · 2026Article
- HIV Infection, Neurotoxicity, Inflammation, Premature Aging, and Therapeutic Challenges to PLWH: An Overview.International journal of molecular sciences · 2026Review
- Feasibility and Implementation Considerations for Long-Acting Antiretroviral Therapy in Pakistan: A Qualitative Study of Healthcare Providers and Programmatic Stakeholders.Journal of the International Association of Providers of AIDS CareArticle
- Health Worker Experiences and Perspectives on the Integration of Long-Acting Injectable Antiretroviral Therapy into a Safety-Net HIV Clinic in the Southeastern United States.Journal of the International Association of Providers of AIDS CareArticle
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Authors and funding
4 authors.
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Abstract
Background: The first long-acting injectable antiretroviral therapy (LAI ART) for HIV was approved for commercial use in the United States in January 2021. Assessment of clinic characteristics and their associations with implementation outcomes and barriers is essential to developing strategies for equitable access to LAI ART. Methods: Using validated implementation measures-acceptability of intervention measure (AIM), intervention appropriateness measure (IAM), and feasibility of intervention measure (FIM)-we conducted a cross-sectional survey of Ryan White clinics in the United States. Additionally, we gathered information on the clinics' population, LAI ART implementation status, and barriers to implementation. Data were analyzed using STATA, version 17. Open-ended responses were analyzed using an inductive thematic approach. Results: Forty-two clinics completed the survey, with 73% in an urban setting. Most clinics identified as either federally qualified health centers (39%) or academic medical centers (27%). The mean (SD) for each measure (maximum of 20) reflected higher AIM (17.7 [2.3]) and IAM (17.6 [2.4]) compared with FIM (16.4 [3.0]). There was a positive correlation between the percentage of patients on Medicaid and summative AIM and IAM scores. The greatest barriers were prior authorizations, drug procurement, and clinic cost of implementation. Conclusions: Despite high acceptability and appropriateness, clinics' perceived feasibility of LAI ART implementation was low. Barriers to implementation include nonstandardization of prior authorizations, obtaining the medication, and cost of implementation. Clinics with a larger Medicaid-insured population reported higher acceptability and appropriateness of LAI ART, suggesting that public insurance might promote equitable access. Interventions that address structural barriers are needed to improve uptake.
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