Clients' perspectives on switching from old stable ART regimens to new dolutegravir-based regimen at joint clinical...

In 2018, Uganda adopted Dolutegravir (DTG)-based regimens as the preferred first-line antiretroviral therapy (ART). This qualitative study explored the perspectives of people living with HIV (PLHIV) regarding switching from stable ART regimens to DTG at the Joint Clinical Research Centre (JCRC). We purposively sampled 24 participants (16 DTG-experienced, 8 DTG-naïve) and conducted face-to-face in-depth interviews. Data were analysed using inductive thematic analysis. DTG-experienced participants were those switched to DTG from a previous stable regimen, while DTG-naïve participants were eligible for but had not yet switched. Key themes emerged: (1) Initial apprehension due to fear of side effects, feeling stable on previous regimens, and perceiving the switch as compulsory or rushed; (2) Appreciation for DTG's benefits (e.g., smaller pill size, once-daily dosing, rapid viral suppression) which mitigated initial hesitancy over time; (3) The critical role of communication and preparation in facilitating a positive transition experience. The findings indicate that while switching from stable treatment initially creates tension, hesitancy decreases as benefits are realized and concerns are addressed through continuous, supportive health education. Effective client-provider communication is essential for successful ART policy transitions.