Medicaid recipients receiving antiretroviral (ARV) treatment for HIV are getting better at staying on treatment, also known as persistence. The median length of time between starting ARVs and hitting a significant gap in taking ARVs grew considerably during the aughts.
Publishing their findings in the journal AIDS, researchers conducted a retrospective cohort study of Medicaid claims from 14 states, analyzing data on 43,598 people with HIV spanning 2001 to 2010.
The researchers looked at ARV refill data and classified individuals as having hit a gap in treatment if they did not fill their HIV medication prescriptions for 90 days plus half the number of days for which the last refill provided medication. In other words, an individual whose last ARV refill was for 30 days was considered to have hit a gap in treatment if he or she did not refill those ARVs for 105 days.
Between 2001 and 2003, the median length of time after which individuals hit a treatment gap was 23.9 months. Between 2004 to 2006, this figure had risen to 35.4 months. Between the end of 2007 to 2010, more than half of the individuals studied were still on ARVs.
After adjusting the data for various factors, the researchers found that those in the 2007 to 2010 era were indeed less likely to hit a treatment gap than those in the first era.
Notably, in 2006, the global SMART study found that taking “drug holidays” from ARV regimens, which was in vogue during the early years of combination HIV treatment, was definitively harmful.
People on single-tablet regimens in the new study were 29 percent less likely to hit a treatment gap than those on six-tablet regimens. After adjusting the data for various factors, including the type of HIV regimen and various demographic characteristics, the study authors found that there was still an upward trend in sticking with ARV regimens.
During the study period, people with HIV also improved in persistence in their regimens for chronic conditions such as cholesterol, high blood pressure and type-2 diabetes. By comparison, data on hundreds of thousands of Medicaid recipients who did not have HIV showed that this population did not improve in rates of persistence in taking such medication regimens during the study period.
To read the study abstract, click here.
To read a press release about the study, click here.