The Perceived Impact of an HIV Cure by People Living With HIV and Key Populations Vulnerable to HIV in the Netherlands: A Qualitative Study

Abstract

Introduction: When an HIV cure becomes available, it will have consequences for people living with HIV (PLHIV) and key populations who are vulnerable to HIV. This qualitative study aimed to explore the perceived impact of two HIV cure scenarios (post-treatment control when HIV is suppressed without the need for ongoing antiretroviral treatment (ART) and complete HIV elimination from the body) on the quality of life (QoL) of PLHIV and key populations living without HIV in the Netherlands.

Methods: Participants were purposefully sampled from the Amsterdam Cohort Studies, the AGEhIV Cohort Study, the outpatient clinic of the University Medical Centre Utrecht and the Dutch HIV Association to increase variability. Semi-structured in-depth interviews were conducted between October 2020 and March 2021 and thematically analysed.

Results: Of the 42 interviewed participants, 29 were PLHIV and 13 represented key populations (i.e., men who have sex with men (MSM) and people injecting drugs). Both PLHIV and vulnerable key population participants hoped that a cure would result in normalization of their lives, by removing the need to disclose HIV, reducing stigma and guilt, increasing independence of ART, and liberating sexual behaviour. Both groups believed only HIV elimination could accomplish this desired impact.

Conclusions: While the post-treatment control scenario seems a more plausible outcome of current HIV cure research, our findings highlight that participants may not perceive it as a true cure. Involvement of PLHIV and vulnerable key populations in devising acceptable and feasible experimental HIV cure approaches is essential to ensure their future successful implementation.

Note:
Funding Information: This work was supported by Aidsfonds Netherlands [grant number P-52901, 2020].

Declaration of Interests: The authors have no competing interests to declare that are relevant to the content of this article.

Ethics Approval Statement: This qualitative study was approved by the ethics committee of the University Medical Centre Utrecht (UMCU): 20-546/C.

Keywords: HIV, cure, quality of life, qualitative research, sexual and gender minorities, sexual behaviour