# Prioritizing long-acting injectable antiretroviral therapy among key populations: Perceptions of persons living with HIV who inject drugs, ART clinic staff, and policymakers in Vietnam

## TL;DR

This study examines how different groups in Vietnam view the prioritization of long-acting HIV treatment for people who inject drugs.

## Contribution

It highlights conflicting perspectives among patients, healthcare workers, and policymakers on fair and effective treatment prioritization.

## Key findings

- PWID emphasized the role of medical providers in treatment decisions.
- Clinic staff considered PWID ideal for LAI due to adherence challenges.
- Policymakers favored prioritizing based on viral suppression and adherence.

## Abstract

We explored perceptions of long-acting injectable (LAI) patient prioritization and decision-making among people who inject drugs (PWID) with HIV, HIV clinic staff, and policymakers in Vietnam.

From February to November 2021, we conducted 38 interviews with 19 PWID, 14 HIV clinic staff, and 5 policymakers in Hanoi, Vietnam. Interviews were coded and analyzed using thematic analysis to assess themes across participants.

PWID highlighted the importance of medical providers in treatment decisions, while clinic staff stressed adequate counseling and patient choice. Non-patient participants viewed adherence to Ministry of Health guidelines as essential, and many clinic staff saw PWID as ideal for LAI due to suboptimal adherence. Policymakers, however, preferred prioritizing LAI based on viral suppression and adherence rather than risk behaviors.

This study reveals conflicting stakeholder views on LAI prioritization, suggesting a need for a more nuanced implementation approach to balance efficiency and fairness in low-resource settings.