Patient preferences regarding antiretroviral therapy

Antiretroviral medications for HIV infection can be combined into dozens of recommended regimens. However, little is known about patient preferences regarding antiretroviral therapy. We assessed the impact of clinician-mutable adherence barriers by conducting four patient focus groups (two English and two Spanish) consisting of 30 patients that focused discussion on antiretroviral treatment preferences. We also surveyed antiretroviral treatment preference from 31 subjects using the method of paired comparisons in which subjects indicated their preferences of regimen potency, pill burden, inconvenience, and side-effects using a 10-point rating scale. We found that most patients would tolerate severe side-effects, inconvenience, and large pill burden to have a potent antiretroviral regimen. In our population, patients generally preferred regimens with fewer side-effects to those with less inconvenience. Pill burden was of least importance among the domains studied. These preferences should be considered when selecting a regimen and developing interventions to improve antiretroviral adherence and patient outcomes.