Preparing HIV services for long-acting injectable treatment and prevention in Uganda: a qualitative study of provider perspectives

Abstract Background Long-acting injectable HIV medicines depend on services able to administer doses and maintain continuing care. Positive provider attitudes suggest readiness only when the basis for their confidence is understood. We investigated how providers assessed readiness for long-acting injectable HIV treatment and prevention in Uganda. Methods A focused secondary qualitative analysis used available English-language provider interview files from a wider study associated with Mildmay Hospital and Kajjansi Health Centre IV. Framework analysis combined organizational domains with comparison of explanations, proposals and contradictory accounts. Interview summaries and case-by-domain matrices preserved the context of readiness judgments. Quotations were checked against source paragraphs. Interviewer prompts informed interpretation. The incomplete corpus precluded saturation claims and comparisons across facilities. Results Four themes explained readiness based on existing HIV services, redistribution of work through injectable delivery, continuing contact as a financed responsibility, and dependable supply. Providers relied on existing personnel, infrastructure and experience with HIV care. Optimism about simpler dispensing coexisted with expectations of additional technical work, larger patient volumes and staff fatigue. Proposed monitoring and outreach depended on financing, leaving uncertainty about responsibility for contact after dosing. Supply confidence rested on different assumptions about early shortage reporting, procurement funding and demand forecasting. Interviewer reassurance and hypothetical staffing arrangements formed part of several readiness exchanges. Providers suggested training, service integration and more accessible delivery, without describing implementation outcomes. Conclusions The interviews distinguish provider confidence in existing HIV services from preparation for the specific work of injectable delivery. Preparation requires assigned responsibilities for administration, appointments and adverse-event contact, financing for these tasks, and continuing supply. The findings capture provider expectations from an incomplete corpus rather than measured facility readiness.