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<p>Singapore has yet to conduct an HIV cure trial, and analytical treatment interruption (ATI) studies may face community scepticism. This study explores the perspectives of people living with HIV and healthcare providers in Singapore on participating in functional cure research involving ATI. Participants were recruited from four HIV care facilities through study advertisements. Healthcare providers were recruited via email. A self-administered survey gathered demographic data, views on ATI and HIV cure, acceptability of ATI, and tolerance for CD4 and viral load changes during ATI. Descriptive, univariate, and multivariable logistic regression analyses were used to identify barriers and motivators to trial participation. Among 200 people living with HIV, 116 (58%) expressed willingness to participate in a cure trial; 84 (42%) did not. Most (94.5%, 189/200) had never joined an HIV clinical study. No significant differences in age, gender, sexuality, or HIV duration were observed between the groups. Factors positively associated with willingness to participate included tertiary education (aOR 2.71, 95% CI 1.13–6.81), altruistic motivations (aOR 1.98, 95% CI 1.52–2.66), and financial compensation (aOR 3.55, 95% CI 1.36–9.88). Lower tolerance for viral load increases or CD4 declines was linked to reduced willingness (aOR 0.77, 95% CI 0.67–0.88). Monitoring frequency, self-testing, and home visits had no significant effect. Healthcare providers were more likely to recommend participation in cure trials if they demonstrated high tolerance for HIV viral load increases (<i>p</i> = 0.044), showed stronger interest in cure research (<i>p</i> = 0.009) and expressed greater acceptance of a functional HIV cure (<i>p</i> = 0.014). Willingness to participate in ATI cure trials is higher among individuals with more education, altruistic intent, and less concern about virologic or immunologic changes. Financial compensation is a strong motivating factor but should not play undue inducement in influencing decision to participate in an ATI cure trial. Community engagement and education are crucial to building support for future HIV cure research.</p>

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Perspectives on Analytical Treatment Interruptions and Prospects of an HIV Cure Amongst People Living with HIV and Healthcare Providers in Singapore

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月17日

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  • Chiaw Yee Choy,
  • Ying Hao,
  • Matthias Paul Han Sim Toh,
  • Sophia Archuleta,
  • Yii Ean Teh,
  • Edwin Yu Sng Chong,
  • Pei Hua Lee,
  • Barnaby Edward Young,
  • P. Arun Kumar,
  • Zannatul Ferdous,
  • Zhi Hui Tan,
  • Tiane Le,
  • Chern Pang Timothy Chia,
  • Lizawati Binte Hamid,
  • Simon Kiat Loon Lee,
  • Andy Lee,
  • Chen Seong Wong

摘要

Singapore has yet to conduct an HIV cure trial, and analytical treatment interruption (ATI) studies may face community scepticism. This study explores the perspectives of people living with HIV and healthcare providers in Singapore on participating in functional cure research involving ATI. Participants were recruited from four HIV care facilities through study advertisements. Healthcare providers were recruited via email. A self-administered survey gathered demographic data, views on ATI and HIV cure, acceptability of ATI, and tolerance for CD4 and viral load changes during ATI. Descriptive, univariate, and multivariable logistic regression analyses were used to identify barriers and motivators to trial participation. Among 200 people living with HIV, 116 (58%) expressed willingness to participate in a cure trial; 84 (42%) did not. Most (94.5%, 189/200) had never joined an HIV clinical study. No significant differences in age, gender, sexuality, or HIV duration were observed between the groups. Factors positively associated with willingness to participate included tertiary education (aOR 2.71, 95% CI 1.13–6.81), altruistic motivations (aOR 1.98, 95% CI 1.52–2.66), and financial compensation (aOR 3.55, 95% CI 1.36–9.88). Lower tolerance for viral load increases or CD4 declines was linked to reduced willingness (aOR 0.77, 95% CI 0.67–0.88). Monitoring frequency, self-testing, and home visits had no significant effect. Healthcare providers were more likely to recommend participation in cure trials if they demonstrated high tolerance for HIV viral load increases (p = 0.044), showed stronger interest in cure research (p = 0.009) and expressed greater acceptance of a functional HIV cure (p = 0.014). Willingness to participate in ATI cure trials is higher among individuals with more education, altruistic intent, and less concern about virologic or immunologic changes. Financial compensation is a strong motivating factor but should not play undue inducement in influencing decision to participate in an ATI cure trial. Community engagement and education are crucial to building support for future HIV cure research.