Knowledge attitudes and practices towards long-acting antiretroviral therapy in HIV/AIDS patients

Why fewer clinic visits matter

For people living with HIV, taking pills every single day can be a constant reminder of illness, a strain on memory, and a source of worry about others noticing their medication. Long-acting injectable treatments, which are given every month or two instead of daily, promise a simpler routine. This study from a large hospital in Beijing asked hundreds of patients what they actually know, feel, and do about these newer long-acting options, and what might stand in the way of using them.

Daily pills versus long-lasting shots

Current HIV treatment usually relies on daily tablets that keep the virus under control and help the immune system recover. While this approach works well, many people struggle to stick to a strict schedule because of pill fatigue, side effects, travel, busy work life, or fear that others will see their medicine. Long-acting injectable therapy offers an alternative: patients who already have the virus under control can receive shots at a clinic every month or two. These injections may ease the burden of constant pill-taking, but they also bring their own challenges, such as injection discomfort, the need for regular clinic visits, and higher costs.

Asking patients what they know and feel

To understand how patients view these long-acting treatments, researchers surveyed 826 people living with HIV who were receiving care at Beijing Youan Hospital. The team used a structured questionnaire to measure three things: knowledge (how much patients knew about HIV and long-acting therapy), attitudes (how they felt about it), and practices (what health-related actions they reported taking). Most respondents were working-age men living in cities, and nearly all were already taking standard daily HIV medicine. The survey also collected background details such as income, education, and how long they had known about their diagnosis.

Limited knowledge but hopeful behavior

The answers revealed a mixed picture. Many participants lacked basic information about how HIV damages the immune system and how standard treatment works over time. Scores on the knowledge scale were generally low, especially for questions about the stages of HIV infection and the role of antiretroviral drugs. Attitudes toward long-acting injections were mostly neutral rather than strongly positive. Fewer than half said they were very willing to try long-acting therapy or to recommend it to others. Yet, when it came to actual or intended behavior, most respondents reported that they would follow clinic schedules, attend tests, and adjust their habits if they were to use long-acting injections. Many already tried to protect their privacy by hiding their pills, and a large share said the main appeal of long-acting therapy was taking medicine less often and avoiding unwanted attention.

How knowledge, feelings, and actions connect

The researchers went beyond simple averages to look at how knowledge, attitudes, and practices fit together. Using statistical models, they found that people who knew more about HIV and long-acting therapy tended to have more positive attitudes, and both stronger knowledge and more favorable attitudes were linked to better health practices. Attitude played a special role: knowledge influenced behavior partly by changing how people felt about treatment. Education level also mattered. Patients with college degrees were more likely to show proactive health behavior, suggesting that social and economic factors shape how easily people can turn information into action. At the same time, cost worries were widespread, and many patients pointed to clinic logistics and doubts about side effects as reasons to hesitate.

What this means for care

Overall, the study suggests that many people living with HIV in this setting are open to the idea of long-acting injections, mainly because they hope to reduce daily treatment burden and protect their privacy. However, their understanding of HIV and long-acting therapy is often shallow, and money and convenience remain major concerns. For long-acting treatments to succeed, health systems will need to pair clear, easy-to-understand education with practical changes that address cost and clinic access. In simple terms, giving people fewer injections instead of many pills will only help if they can afford the shots, trust their safety, and feel confident about how the treatment fits into their lives.

Citation: Ren, M., Duan, J., Huang, T. et al. Knowledge attitudes and practices towards long-acting antiretroviral therapy in HIV/AIDS patients. Sci Rep 16, 15840 (2026). https://doi.org/10.1038/s41598-026-44035-0

Keywords: HIV treatment, long-acting therapy, injectable ART, patient attitudes, treatment adherence