Health worker' perceptions of risks, barriers to and facilitators of long-acting injectable antiretroviral therapy delivery to women for prevention of vertical transmission programs

This study examines the perceptions and experiences of health workers and caregivers regarding the delivery of long-acting antiretroviral therapy (LA-ART) in Uganda, especially for preventing vertical transmission of HIV. Using a qualitative implementation research design informed by the Health Belief Model, the researchers conducted 17 key informant interviews with clinicians, nurses, peer mothers, social workers, department heads, and lead researchers across six study centers between May 2022 and September 2023. The interviews were recorded and transcribed verbatim into English language and analyzed thematically using NVivo 14. Five key themes emerged: perceived benefits, perceived barriers, facility readiness, and recommendations for implementation. Health workers highlighted benefits such as treatment convenience, improved adherence, and patient acceptance. However, they also identified major barriers, including stigma, limited staff training, and financial constraints. Concerns about health facility readiness particularly cold chain storage for the injectable medication were also noted. The findings underscore the importance of addressing these challenges to support effective LA-ART delivery. The study recommends comprehensive training for healthcare workers, patient education, and a phased rollout strategy. Understanding the views of frontline workers is crucial for the successful integration of LA-ART into HIV care and improving health outcomes for people living with HIV.