For years, taking a pill every day has been part of daily life for people with HIV.
A large new review suggests most would consider a different routine, if given the choice.
The analysis, published online in the journal AIDS on 5 June 2026, pooled findings from 22 earlier studies covering thousands of people with HIV, most of them in Europe and North America.
The authors, led by first author Kyra F. Mendes de Leon and colleagues at Amsterdam University Medical Center in the Netherlands, said this is the first review to bring this evidence together.
Using a statistical method that combines results across studies, they found that willingness to switch to some form of long-acting treatment stood at 70 percent, with the true figure estimated to fall somewhere between 59 and 79 percent.
A long-acting regimen is designed to replace at least some daily pill-taking with something given far less often.
In practice this has mostly meant an injection, though the review also looked at hypothetical options such as implants placed under the skin, infusions, and tablets taken only once a week.
Evidence on those alternatives remains limited.
The main injectable option combines two drugs, cabotegravir and rilpivirine, first approved in several countries starting in 2021.
It was initially approved as a monthly injection before regulators in some countries, including the United States, approved a less frequent every-two-month schedule the following year.
Each treatment visit involves two separate injections, and availability and approved dosing still vary from country to country.
For the two-monthly injection specifically, the most studied option, pooled willingness came out lower, at 60 percent.
Results swung dramatically between individual studies, from as low as 24 percent willing in one Italian study to as high as 83 percent in a Spanish one.
The researchers tested several possible explanations for that swing, including where a study was done, how it was funded, and how it was designed, and found that none of these factors accounted for the differences.
Almost all of this evidence describes what people said they would prefer, not what they actually did.
Only two of the 22 studies followed people who were offered a real, immediate choice.
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Both found some difference between what people said and what they actually did, but the difference was not statistically significant, and the researchers said the data were too limited to draw firm conclusions.
The researchers noted that stated preferences in health research often run ahead of real decisions, a pattern known as optimism bias.
Beyond convenience, the researchers pointed to the emotional weight of a daily routine.
Taking a pill every day can serve as a constant reminder of a person's HIV status, and a missed dose can bring on anxiety.
For people who have not told everyone around them about their status, a less visible treatment schedule can mean more privacy.
Other studies cited in the review found needle fear working in the opposite direction, discouraging some people from making the switch.
Of the 22 studies in the review, only one came from a low or middle income country.
That stands out because, citing 2025 World Health Organization figures, the researchers noted that roughly two out of three people living with HIV worldwide live in such countries.
Earlier research the team cited suggests interest in long-acting treatment may actually run higher in lower income settings, partly because HIV-related stigma tends to be more pronounced there and a less visible treatment could offer real relief.
Despite that apparent demand, the researchers described long-acting treatment as still largely unavailable in these settings, pointing to cost, the cold storage chain injectable drugs require, and a shortage of staff trained to administer them as recurring barriers.
About a third of the studies in the review carried a higher risk of bias, most often because the people who took part were not fully representative of people with HIV more broadly.
The review's senior author, Marc van der Valk, disclosed research funding and advisory fees from three companies that make HIV treatments, ViiV, Gilead and MSD, paid to his institution rather than to him personally.
The other three researchers reported no such ties.
The researchers said the underrepresentation of lower income countries in this evidence base needs to be addressed, calling for more geographically diverse research so that future HIV treatment policy reflects the preferences of the populations who would actually use it.
Source: Mendes de Leon KF, Klungers RD, Nieuwkerk PT, Van Der Valk M. Willingness to switch to long-acting regimens among people with HIV: a systematic review and meta-analysis. AIDS. 2026 Jun 5. doi:10.1097/QAD.0000000000004556
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