title: Qualitative study of the BREATHER trial (Short Cycle antiretroviral therapy): is it acceptable to young people living with HIV?
abstract: A qualitative study of the BREATHER (PENTA 16) randomised clinical trial, which compared virological control of Short Cycle Therapy (SCT) (5 days on: 2 days off) with continuous efavirenz (EFV)-based antiretroviral therapy (CT) in children and young people (aged 8-24) living with HIV with viral load <50 c/mL to examine adaptation, acceptability and experience of SCT to inform intervention development.
  
  
  
  Paediatric HIV clinics in the UK (2), Ireland (1), the USA (1) and Uganda (1).
  
  
  
  All BREATHER trial participants who were over the age of 10 and aware of their HIV diagnosis were invited to participate. 49 young people from both arms of the BREATHER trial (31 females and 18 males; 40% of the total trial population in the respective sites; age range 11-24) gave additional consent to participate in the qualitative study.
  
  
  
  Young people from both trial arms had initial concerns about the impact of SCT on their health and adherence, but these decreased over the early months in the trial. Young people randomised to SCT reported preference for SCT compared with CT pre-trial. Attitudes to SCT did not vary greatly by gender or country. Once short-term adaptation challenges were overcome, SCT was positively described as reducing impact of side effects, easing the pressure to carry and remember medication and enabling more weekend social activities. Young people on both arms reported frequent medication side effects and occasional missed doses that they had rarely voiced to clinical staff. Participants liked SCT by trial end but were concerned that peers who had most problems adhering could find SCT disruptive and difficult to manage.
  
  
  
  To realise the potential of SCT (and mitigate possible risks of longer interruptions), careful dissemination and communication post-trial is needed. SCT should be provided alongside a package of monitoring, support and education over 3 months to allow adaptation.
  
  
  
  NCT 01641016.
authors.affiliation: Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bernays
authors.affiliation: Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Sara
authors.initials: S
authors.lastname: Paparini
authors.affiliation: Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London, UK.|MRC/UVRI Uganda Research Unit on AIDS, Social Science Programme, Entebbe, Uganda.
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
authors.affiliation: MRC/UVRI Uganda Research Unit on AIDS, Social Science Programme, Entebbe, Uganda.
authors.forename: Stella
authors.initials: S
authors.lastname: Namukwaya Kihika
authors.affiliation: MRC Clinical Trials Unit at UCL, London, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Gibb
authors.affiliation: Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Rhodes
mesh_terms: D000293:Adolescent; D000480:Alkynes; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D048588:Benzoxazines / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D003521:Cyclopropanes; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D014342:Truth Disclosure; D019562:Viral Load; D055815:Young Adult
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; C098320:efavirenz
keywords: HIV; PAEDIATRICS; antiretroviral therapy