Towards inclusive HIV cure development: Identifying important and acceptable HIV cure attributes and strategies among people with HIV in the Netherlands

Abstract

Objectives: Initial HIV cure interventions may not meet expert-defined target product profiles (TPPs; desired treatment attributes). Understanding how people with HIV perceive ideal and likely HIV cure attributes is essential. This study examined which optimal TPP attributes people with HIV consider important and which minimum attributes and strategies they find acceptable. Additionally, it explored patterns of importance and their association with the acceptance of minimum attributes and cure strategies. Methods: A cross-sectional survey (July 2023–March 2024) among 420 people with HIV assessed the importance of eight optimal attributes, the acceptability of fifteen minimum attributes, and five prominent cure strategies. Latent class analysis identified groups of people with different patterns of importance ratings. Results: Optimal HIV cure attributes most frequently endorsed as important were ‘no HIV transmission risk’ (76.4%), ‘immune system recovery’ (66.4%), and ‘protection from reinfection’ (63.8%). Twelve of fifteen minimum attributes and all cure strategies were acceptable (mean > 3). Four latent classes of importance ratings emerged: exacting (N = 129, 30.7%; all attributes important), ambivalent (N = 121, 28.8%; neutral ratings), indifferent (N = 28, 6.7%; most attributes unimportant/neutral), and selective (N = 142, 35.2%; most attributes important except cure regimen-related factors). ANOVAs showed that participants with ambivalent importance patterns were less accepting of minimum attributes and strategies, while participants with indifferent importance patterns were more accepting of unacceptable minimum attributes. Conclusions: People with HIV in the Netherlands find most HIV cure interventions acceptable, even if they do not meet optimal TPPs. However, perspectives differ across subgroups.