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February 19, 2026
UAB leads study to mitigate the medication adherence barriers in those living with HIV
 Aadia Rana, M.D.
Photo by: Ian Logue
Medication adherence remains a challenge across all chronic conditions, commonly imposed by financial, physical or educational factors with impact on personal health outcomes. In infectious diseases like HIV, in addition to impacting individual health, reduced adherence to medications also results in ongoing transmission of the virus, reflecting the significant public health impact and limiting efforts to end the HIV epidemic.
Investigators at the University of Alabama at Birmingham led a study from the ACTG, an NIH-funded global clinical trials network focused on HIV and other infectious diseases, to target the challenges of adherence in those living with HIV.
A paper in the New England Journal of Medicine published the findings of the LATITUDE study, a phase three efficacy study of the long-acting injectable antiretroviral therapies cabotegravir and rilpivirine in those who have been diagnosed with HIV and have a history of adherence challenges.
Led by Aadia Rana, M.D., professor of medicine in the UAB Marnix E. Heersink School of Medicine Division of Infectious Diseases, findings from the LATITUDE study indicate that the long-acting injectables cabotegravir and rilpivirine were superior in preventing regimen failure among people living with HIV who have struggled with adherence to daily oral antiretroviral therapy (ART).
“In the United States, almost 40 percent of people living with HIV are not receiving the full benefits of antiretroviral therapy,” Rana said. “This is true in Alabama as well and is one of the main reasons we continue to see a stagnant rate of new HIV infections here annually.”
With an estimated 67 percent of people living with HIV in the United States taking oral ART maintaining viral suppression, this study is the first randomized study seeking to determine whether this long-acting approach could achieve consistent virologic suppression among people who have difficulty taking oral ART.
Of the 453 participants who were enrolled, participants first started oral ART along with conditional economic incentives to achieve viral suppression in order to be eligible for randomization. There were 306 participants randomized and divided into two groups with one group of 152 receiving monthly injectables of cabotegravir and rilpivirine and the second group of 154 receiving daily oral ART. In February 2024, the trial was halted early due to interim study review findings of significantly reduced rates of virologic failure and treatment-related failure in the injectable group. These findings are validated in this publication which includes final analysis of trial data confirming superiority of the monthly injectables in preventing regimen failure compared to daily oral ART. The oral ART group was almost twice as likely to have regimen failure at 41.2 percent compared to the injectable group which had a failure rate of 22.8 percent.
Rana emphasized the importance of clinical trials including populations representative of the HIV epidemic.
“This study enrolled participants from 33 sites across the United States who face challenges with consistent engagement in care including those with active substance use, mental health issues, and unstable housing,” she said. “This is exactly the population we need to target when testing interventions to end the HIV epidemic.”
With UAB serving as one of the top enrolling sites, Rana says she is committed to helping end the epidemic in the state and the South.
“The Southeast United States is the region most disproportionately impacted by the HIV epidemic with higher rates of HIV incidence and lower rates of viral suppression,” Rana said. “The priority is now to determine which implementation strategies, including collaborations with our public health agencies and community partners, will result in effective and cost-efficient workflows to ensure access of these medications to those who may benefit most.”
Co-chair authors on the study include Raphael J. Landovitz, M.D., M.Sc., of the University of California Los Angeles and Karen Tashima, M.D., of Brown University. The University of Cincinnati also served as an enrollment site for study participants. ACTG is led by Joseph J. Eron, M.D., and ACTG Vice Chair Rajesh T. Gandhi, M.D., of Massachusetts General Hospital and Harvard Medical School. LATITUDE is sponsored by the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, which also funds ACTG, under award numbers UM1 AI068636, UM1 AI107716 and UM1 AI068634, and received additional funding from UTHealth Houston McGovern School of Medicine. ViiV Healthcare and Johnson & Johnson provided medications for the study.
Source: https://www.uab.edu/news/research-innovation/uab-leads-study-to-mitigate-the-medication-adherence-barriers-in-those-living-with-hiv
Media contact
Micah Hardge | Media Specialist
Office of Marketing and Communications
UAB | The University of Alabama at Birmingham
micahxh@uab.edu
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