<p>LAI-ART awareness & acceptability.</p>

In the final adjusted multivariable models, prior awareness of LAI-ART was a powerful independent predictor, nearly tripling a patient’s willingness to switch (aOR = 2.851; 95% CI: 1.742–4.666; p < 0.001). Finding information through online resources (aOR = 2.246; 95% CI: 1.303–3.873; p = 0.004) and missing oral pill doses (aOR = 2.154; 95% CI: 1.266–3.664; p = 0.005) both independently more than doubled a participant’s odds of finding LAI-ART acceptable.

Conversely, the enrollment hospital site had no independent statistical effect on acceptability once the analysis controlled for baseline demographics and how often individuals must visit the hospital for care (aOR = 1.188; 95% CI: 0.659–2.141; p = 0.567). Drivers of interest among those willing to switch included reducing pill burden (77.8%), avoiding forgetting doses (55.6%), and improving privacy (45.5%). Despite high baseline acceptability, focus group discussions revealed a state of cautious optimism, driven by significant fears of potential side effects (68.1%), treatment rigidity, and logistical challenges such as travel and clinic access.</p> <p>Conclusion</p><p>These findings suggest that although LAI-ART is widely viewed as a promising treatment option, its uptake will depend on effective patient-centered communication, increased awareness, trust in the intervention, and reliable service delivery.

However, successful implementation in Kenya will require more than patient willingness alone. Health system readiness must be a central consideration, with implementation strategies focused on securing dependable drug supply chains, decentralizing access through county-level clinics, and strengthening digital systems to support patient monitoring, retention, and continuity of care.</p></div>