Published in PLOS One on 2026-09-30, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Duncan Nyukuri, Melanie Abongo, Anastacia Mbithi, Christine Kundu, Kenneth Mutai, Reena Chhotala Shah
Source: PLOS One • DOI 10.1371/journal.pone.0320713
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Long-acting injectable antiretroviral therapy offers an alternative to daily oral HIV treatment, potentially improving adherence and reducing stigma. While its adoption has been successful in some settings, evidence on its acceptability in sub-Saharan Africa, outside clinical trials, remains limited.
We conducted a mixed-methods study among people living with HIV (PLHIV) in two tertiary hospitals in Nairobi, Kenya—a public facility (Kenyatta National Hospital) and a private facility (Aga Khan University Hospital). A cross-sectional survey of 356 participants assessed awareness, willingness to switch, and predictors of acceptability. In addition, 30 participants took part in three focus group discussions (FGDs) exploring perceptions, concerns, and system-level considerations. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were analyzed thematically.
Overall, 72.2% of survey participants indicated a willingness to switch to LAI-ART. In the final adjusted multivariable models, prior awareness of LAI-ART was a powerful independent predictor, nearly tripling a patient’s willingness to switch (aOR = 2.851; 95% CI: 1.742–4.666; p < 0.001). Finding information through online resources (aOR = 2.246; 95% CI: 1.303–3.873; p = 0.004) and missing oral pill doses (aOR = 2.154; 95% CI: 1.266–3.664; p = 0.005) both independently more than doubled a participant’s odds of finding LAI-ART acceptable. Conversely, the enrollment hospital site had no independent statistical effect on acceptability once the analysis controlled for baseline demographics and how often individuals must visit the hospital for care (aOR = 1.188; 95% CI: 0.659–2.141; p = 0.567). Drivers of interest among those willing to switch included reducing pill burden (77.8%), avoiding forgetting doses (55.6%), and improving privacy (45.5%). Despite high baseline acceptability, focus group discussions revealed a state of cautious optimism, driven by significant fears of potential side effects (68.1%), treatment rigidity, and logistical challenges such as travel and clinic access.
These findings suggest that although LAI-ART is widely viewed as a promising treatment option, its uptake will depend on effective patient-centered communication, increased awareness, trust in the intervention, and reliable service delivery. However, successful implementation in Kenya will require more than patient willingness alone. Health system readiness must be a central consideration, with implementation strategies focused on securing dependable drug supply chains, decentralizing access through county-level clinics, and strengthening digital systems to support patient monitoring, retention, and continuity of care.
Introduction
Long-acting injectable antiretroviral therapy (LAI-ART) offers a promising alternative to the daily pill regimen for treating HIV. Administered every two months, this innovative therapy could simplify treatment, improve patient adherence, and boost retention in care [1,2].
This is especially critical in sub-Saharan Africa (SSA), a region that carries two-thirds of the 40 million people living with HIV worldwide [3]. In Kenya, for example, where 1.4 million people are living with HIV [4], persistent adherence challenges are common due to factors such as pill burden, treatment fatigue, and stigma [5]. These issues are particularly pronounced among adolescents and young people, who often have significantly lower adherence rates than older adults due to heightened stigma and challenges during their transition to adulthood [6]. Consequently, there is an urgent need to explore new and creative strategies to address the unique challenges of the region.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Duncan Nyukuri, Melanie Abongo, Anastacia Mbithi, Christine Kundu, Kenneth Mutai, Reena Chhotala Shah. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Implementation bottlenecks of near point of care HIV viral load monitoring for children and young people in Tanzania: A Qualitative Study
