Table 1.
Long-Acting Injectable Antiretroviral Therapy Key Questions and Relevant Considerations by Practical, Robust Implementation and Sustainability Model Domain
| PRISM domain | Key questions | Considerations |
|---|---|---|
| Intervention | What concerns do patients have about LAI-ART? | • Efficacy |
| • Side effects | ||
| • Clinic visits | ||
| • Fear of needles/injections | ||
| • Number of injections per dose | ||
| • Frequency of injections | ||
| • Bodily location of injections | ||
| • Cost | ||
| What concerns do providers have about LAI-ART? | • Efficacy | |
| • Side effects | ||
| • Clinic visits | ||
| • Number of injections per dose | ||
| • Frequency of injections | ||
| • Cost | ||
| • Modality | ||
| • Resistance | ||
| • Oral lead-in/PK tail | ||
| • DDIs | ||
| • Clinical management/resources | ||
| Recipients | At which patient populations is LAI-ART best directed? | • People non-adherent to pills |
| • Women/pregnant women | ||
| • People with substance abuse challenges | ||
| • People with mental challenges | ||
| • Unstably housed | ||
| • Youth/adolescents | ||
| Which organizations/providers are best suited to administer LAI-ART? | • Hospitals | |
| • HIV specialists | ||
| • PCPs | ||
| • Clinics | ||
| • Pharmacies | ||
| • Community health centers | ||
| • Shot clinics | ||
| External environment | What external factors bear on the implementation of LAI-ART? | • Regulatory environment |
| • Health care reform/ACA | ||
| • Medicaid expansion | ||
| • Preexisting conditions | ||
| • Exchange plans | ||
| • Payers | ||
| • Third party payers | ||
| • Medicare/Medicaid | ||
| • Uninsured | ||
| • Stigma | ||
| • HIV | ||
| • Homophobia | ||
| • Transphobia | ||
| • Systemic racism | ||
| Infrastructure | What is needed to craft a sustainable infrastructure for LAI-ART? | • Appropriate venue |
| • Venue logistics/patient flow | ||
| • Patient/provider education |
PRISM, Practical, Robust Implementation and Sustainability Model; LAI-ART, long-acting injectable antiretroviral therapy; PK, pharmacokinetic; DDI, drug–drug interaction; PCP, primary care provider; ACA, Affordable Care Act.