{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T01:06:20Z","timestamp":1779930380009,"version":"3.53.1"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U01AI135940"],"award-info":[{"award-number":["U01AI135940"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Monthly intravenous infusion of broadly neutralizing monoclonal antibodies may be an attractive alternative to daily oral antiretroviral treatment for children living with HIV. However, acceptability among caregivers remains unknown.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We evaluated monthly infusion of dual bNAbs (VRCO1LS and 10\u20131074) as a treatment alternative to ART among children participating in the Tatelo Study in Botswana. Eligible children aged 2\u20135 years received 8\u201332 weeks of bNAbs overlapping with ART, and up to 24 weeks of bNAbs alone as monthly intravenous infusion. Using closed-ended questionnaires, we evaluated caregiver acceptability of each treatment strategy prior to the first bNAb administration visit (pre-intervention) and after the completion of the final bNAb administration visit (post-intervention).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Twenty-five children completed the intervention phase of the study, and acceptability data were available from 24 caregivers at both time points. Responses were provided by the child\u2019s mother at both visits (60%), an extended family member at both visits (28%), or a combination of mother and an extended family member (12%). Caregiver acceptance of monthly bNAb infusions was extremely high both pre-and post-intervention, with 21\/24 (87.5%) preferring bNAbs to ART pre-intervention, and 21\/25 (84%) preferring bNAbs post-intervention. While no caregiver preferred ART pre-intervention, 2\/25 preferred it post-intervention. Pre-intervention, 3 (13%) caregivers had no preference between monthly bNAbs or daily ART, and 2 (8%) had no preference post-intervention. Pre-intervention, the most common reasons for preferring bNAbs over ART were the perception that bNAbs were better at suppressing the virus than ART (n = 10) and the fact that infusions were dosed once monthly compared to daily ART (n = 9). Post-intervention, no dominant reason for preferring bNAbs over ART emerged from caregivers.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Monthly intravenous bNAb infusions were highly acceptable to caregivers of children with HIV in Botswana and preferred over standard ART by the majority of caregivers.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Clinical Trial Number<\/jats:title>\n<jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03707977\" xlink:type=\"simple\">NCT03707977<\/jats:ext-link>.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0299942","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T17:38:14Z","timestamp":1711561094000},"page":"e0299942","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Caregivers of children with HIV in Botswana prefer monthly IV Broadly Neutralizing Antibodies (bNAbs) to daily oral ART"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5222-7756","authenticated-orcid":true,"given":"Maureen","family":"Sakoi-Mosetlhi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5408-4823","authenticated-orcid":true,"given":"Gbolahan","family":"Ajibola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxanna","family":"Haghighat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oganne","family":"Batlang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Maswabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Pretorius-Holme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen M.","family":"Powis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Lockman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Makhema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Litcherfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"Kuritzkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Shapiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"issue":"46","key":"pone.0299942.ref001","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.15585\/mmwr.mm6546a2","article-title":"Early diagnosis of HIV infection in infants\u2014one Caribbean and six sub-Saharan African countries, 2011\u20132015","volume":"65","author":"K. Diallo","year":"2016","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"pone.0299942.ref002","unstructured":"(UNAIDS), T.J.U.N.P.o.H.A., Children and HIV Fact Sheet. 2016: Online."},{"issue":"63","key":"pone.0299942.ref003","article-title":"Early ART-initiation and longer ART duration reduces HIV-1 proviral DNA levels in children from the CHER trial","volume":"18","author":"H. Payne","year":"2021","journal-title":"AIDS Res Ther"},{"key":"pone.0299942.ref004","unstructured":"Children, HIV and AIDS: Regional snapshot\u2014Sub-saharan Africa. 2019."},{"issue":"8","key":"pone.0299942.ref005","first-page":"783","article-title":"Antiretroviral Therapy in Children and Adolescents: A Look Into Modern Single Tablet Regimens","volume":"26","author":"C. Lee","year":"2021","journal-title":"J Pediatr Pharmacol Ther"},{"issue":"2","key":"pone.0299942.ref006","doi-asserted-by":"crossref","first-page":"181","DOI":"10.4103\/ijstd.IJSTD_43_18","article-title":"Factors affecting adherence to treatment in children living with HIV","volume":"41","author":"D. Verma","year":"2020","journal-title":"Indian J Sex Transm Dis AIDS"},{"issue":"11","key":"pone.0299942.ref007","doi-asserted-by":"crossref","first-page":"2729","DOI":"10.1007\/s10461-016-1419-5","article-title":"Assessing Adherence to Antiretroviral Therapy in a Rural Paediatric Cohort in KwaZulu-Natal, South Africa","volume":"20","author":"C. Smith","year":"2016","journal-title":"AIDS Behav"},{"issue":"9","key":"pone.0299942.ref008","doi-asserted-by":"crossref","first-page":"e0275420","DOI":"10.1371\/journal.pone.0275420","article-title":"Magnitude and associated factors of anti-retroviral therapy adherence among children attending HIV care and treatment clinics in Dar es Salaam, Tanzania","volume":"17","author":"F.M. Mussa","year":"2022","journal-title":"PLoS One"},{"issue":"5","key":"pone.0299942.ref009","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1177\/2325957414557264","article-title":"Development of Severe Anemia and Changes in Hemoglobin in a Cohort of HIV-Infected Ugandan Adults Receiving Zidovudine-, Stavudine-, and Tenofovir-Containing Antiretroviral Regimens","volume":"14","author":"R. 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Ajibola","year":"2021","journal-title":"Clin Infect Dis"},{"key":"pone.0299942.ref030","unstructured":"(W.H.O), W.H.O., Paediatric Antiretroviral Drug Optimization (PADO) Meeting 4 report. 2018: Geneva."},{"issue":"5","key":"pone.0299942.ref031","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/QAI.0000000000003147","article-title":"Brief Report: Long-Term Clinical, Immunologic, and Virologic Outcomes Among Early-Treated Children With HIV in Botswana: A Nonrandomized Controlled Clinical Trial","volume":"92","author":"G. 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