PARI project

The context

Two molecules, cabotegravir and rilpivirine, have been authorised in France and routinely prescribed since the end of 2021.

Administered by injection every two months, they are an alternative to daily oral treatments, acceptable and effective in people living with HIV (PLHIV) who are treated and controlled, with no known or suspected resistance to the two molecules.

However, there is still little evidence on the practical implementation of this new treatment option. Beyond efficacy, tolerance and acceptability, there are also concerns about their accessibility, the context, modalities and effects of their availability, especially with the forthcoming arrival of other LA ARVs, such as lenacapavir.

What is the aim of PARI?

The main objective of the ANRS 0773s PARI project is to understand the conditions of access to long-acting antiretrovirals (LA-ARVs) in France and their clinical and social effects, in order to identify any inequalities in access. The project will be conducted over three years.

More specifically, this involves:

• describing and analysing contexts in which LA-ARVs are implemented in France – where, how and to whom these treatments are prescribed – and identifying any regional and social inequalities in access
• analysing the effect of the diversity of implementation contexts and PLHIV profiles on long-term prescription and use in order to identify any structural and social inequalities
• understanding the conditions for prescribing and using these treatments from the perspective of healthcare professionals and the PLHIV concerned, as well as their social effects, to highlight mechanisms that produce identified inequalities
• describing and analysing virological and clinical efficacy, causes of treatment discontinuation and associated factors according to PLHIV profiles and criteria for initiating treatment
• promoting the use of knowledge produced within the framework of this project through the implementation of a knowledge transfer strategy

This social science research will be conducted using socio-demographic and clinical data from an existing PLHIV cohort, the ANRS CO4 FHDH cohort.

This original research project brings together researchers from various disciplines, healthcare professionals and community organisations involved in the research process. It draws on a wide range of expertise and aims to produce useful knowledge for the populations concerned, both by sharing experience and expertise. It is therefore part of the participatory research approach.