Switching to Long-Acting Cabotegravir and Rilpivirine in Turkey: Perspectives from People Living with HIV in a Setting of Increasing HIV Incidence
Rıdvan Dumlu,
Yeliz Çiçek,
Mahir Kapmaz,
Okan Derin,
Halis Akalın,
Uğur Önal,
Egemen Özdemir,
Çiğdem Ataman Hatipoğlu,
Günay Tuncer Ertem,
Alper Şener,
Leyla Akgül,
Yeşim Çağlar,
Derya Tuna Ecer,
Mustafa Kemal Çelen,
Nur Bahar Oğuz,
Figen Yıldırım,
Deniz Borcak,
Sevtap Şenoğlu,
Eyüp Arslan,
Sinan Çetin,
Meryem Balcı,
Ali Mert
Affiliations
Rıdvan Dumlu
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Istanbul 34214, Turkey
Yeliz Çiçek
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Istanbul 34214, Turkey
Mahir Kapmaz
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Istanbul 34214, Turkey
Okan Derin
Epidemiology PhD Program, Graduate School of Health Sciences, Istanbul Medipol University, Istanbul 34810, Turkey
Halis Akalın
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bursa Uludağ University, Bursa 16059, Turkey
Uğur Önal
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bursa Uludağ University, Bursa 16059, Turkey
Egemen Özdemir
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bursa Uludağ University, Bursa 16059, Turkey
Çiğdem Ataman Hatipoğlu
Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara 06230, Turkey
Günay Tuncer Ertem
Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara 06230, Turkey
Alper Şener
Department of Infectious Diseases and Clinical Microbiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey
Leyla Akgül
Department of Infectious Diseases and Clinical Microbiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey
Yeşim Çağlar
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Balikesir University, Balikesir 10145, Turkey
Derya Tuna Ecer
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Balikesir University, Balikesir 10145, Turkey
Mustafa Kemal Çelen
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir 21280, Turkey
Nur Bahar Oğuz
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir 21280, Turkey
Figen Yıldırım
Department of Infectious Diseases and Clinical Microbiology, Antalya Vakif Yasam Hospital, Antalya 07060, Turkey
Deniz Borcak
Department of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul 34147, Turkey
Sevtap Şenoğlu
Department of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul 34147, Turkey
Eyüp Arslan
Department of Infectious Diseases and Clinical Microbiology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul 34785, Turkey
Sinan Çetin
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Giresun University, Giresun 28200, Turkey
Meryem Balcı
Department of Infectious Diseases and Clinical Microbiology, Hakkari State Hospital, Hakkari 30000, Turkey
Ali Mert
Department of Internal Medicine, Faculty of Medicine, Istanbul Medipol University, Istanbul 34214, Turkey
Background and Objectives: Long-acting cabotegravir and rilpivirine (LA-CAB/RPV) offers an alternative to daily oral antiretroviral therapy (ART) for people living with HIV (PLWH). Although LA-CAB/RPV has been approved in Turkey, the country remains in the pre-rollout period, and national data on patient perspectives are lacking. This is the first nationwide study from Turkey, a setting of increasing HIV incidence, assessing PLWH perspectives on switching to LA-CAB/RPV and the influence of motivational factors on treatment preferences. Materials and Methods: A prospective, multicenter, cross-sectional study was conducted across 11 HIV treatment centers representing all regions of Turkey. Virologically suppressed PLWH meeting current eligibility criteria for LA-CAB/RPV were included. Treatment preferences (switch to LA-CAB/RPV or remain on oral ART) and five anticipated motivational domains, namely perceived efficacy, safety, convenience, privacy, and cost, were systematically assessed through structured, face-to-face interviews. Results: Among 200 eligible participants, 86% (n = 172) preferred switching to LA-CAB/RPV. In all subgroups, LA-CAB/RPV was preferred over oral ART, except for those with no formal literacy. Prior awareness of LA-CAB/RPV was significantly associated with the switching preference (p n = 172) (p p = 0.018) and all motivational factors significantly influenced the preference (p Conclusions: High clinical eligibility and strong acceptability for LA-CAB/RPV were observed among Turkish PLWH. Our findings demonstrate that structured motivational factors significantly influence the treatment preference. Addressing these patient-centered factors and logistical barriers may support the successful integration of long-acting therapies into routine HIV care. Future longer-interval agents may improve patient-centered acceptability.
