ArticleAIDS and behavior2024
Antiretroviral Treatment Gaps and Adherence Among People with HIV in the U.S. Medicare Program.
Article in AIDS and behavior, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 24 citations in OpenAlex.
- Prevalence of and Time to Suboptimal Treatment Patterns Among People with HIV on Antiretroviral Therapy in the United States.AIDS and behavior · 2026Observational
- Epigenetic Age Acceleration Is Associated With HIV Infection Independently of Inflammation.Open forum infectious diseases · 2026Article
- Antiretroviral therapy switch among Medicare beneficiaries with HIV.Journal of managed care & specialty pharmacy · 2026Article
- Burden of comorbid disease, treatment, and healthcare utilization among people with HIV: A retrospective, cross-sectional study from a large healthcare organization.Epidemiology and infection · 2026Article
- Nationwide patterns of HIV drug resistance and high viral load in Sub-Saharan African countries.The Journal of antimicrobial chemotherapy · 2026Article
- Real-World Persistence After Starting Bictegravir- or Dolutegravir-Based Regimens Among Adults Aged ≥50 Years with HIV in the United States.Drugs & aging · 2026Article
- "Nobody's Going to Say No to a Dollar": Framing HIV Medication Diversion Through the Lens of Economies of Diversion.AIDS and behavior · 2026Article
- Antiretroviral Treatment Switch Among Treatment-Experienced People with HIV.Journal of health economics and outcomes research · 2026Article
- Treatment Persistence and Switch Among Medicare-Insured People with HIV and Gaps in Care.Infectious diseases and therapy · 2026Article
- Modeling the Public Health Impact of Improved Antiretroviral Therapy Restart Patterns Among People with HIV Who Have Discontinued Treatment.Journal of health economics and outcomes research · 2026Article
- Outcomes of Rapid Restart Among People With Previously Diagnosed HIV at a Safety-Net HIV Clinic in San Francisco.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Provider Perspectives on the Data-to-Suppression Initiative in Ryan White Part A Housing and Behavioral Health Programs.AIDS patient care and STDs · 2025Article
- Characterizing treatment interruptions in the OPERA cohort and virologic outcomes after resumption with bictegravir/emtricitabine/tenofovir alafenamide.AIDS research and therapy · 2025Article
- Policy Impediments to Tuberculosis Elimination: Consequences of an Absent Medicare National Coverage Determination for Tuberculosis Prevention.Journal of immigrant and minority health · 2025Article
- Efficacy of Bictegravir/Emtricitabine/Tenofovir Alafenamide (B/F/TAF) After A Viremic Event: A Pooled Analysis of Studies in People with HIV.Infectious diseases and therapy · 2025Article
- Missed Follow-Up and Kaposi Sarcoma Progression: The Consequences of Medication Non-adherence.Cureus · 2025Article
- Characterizing disparities in the HIV care continuum among U.S. transgender and cisgender Medicare beneficiaries, 2008-2017.AIDS care · 2025Article
- Effect of Machine Learning on Risk Stratification for Antiretroviral Treatment Failure in People Living with HIV.Infection and drug resistance · 2025Article
- Antiretroviral Therapy Use and Disparities Among Medicare Beneficiaries with HIV.Journal of general internal medicine · 2024Observational
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
Approximately one-quarter of people with HIV (PWH) in the U.S. receive coverage through the Medicare program; however, no prior real-world study has examined antiretroviral therapy (ART) gaps and adherence and associated factors in this population. This retrospective cohort analysis used 2013-2018 national Medicare fee-for-service claims data to identify all PWH initiated on a new ART regimen including protease inhibitors [PI], non-nucleoside reverse transcriptase inhibitors [NNRTIs], or integrase strand transfer inhibitors [INSTIs] between 1/1/2014 and 12/31/2017. Study outcomes included ART adherence (based on proportion of days covered [PDC]), continuous treatment gaps ranging from 1 to 6 days to ≥ 180 days, and discontinuation (continuous gap ≥ 90 days) in the 12-month follow-up period. Multivariable regressions were used to assess factors associated with ART adherence and discontinuation. The final sample included 48,627 PWH (mean age: 54.5 years, 74.4% male, 47.5% White, 89.8% disabled). Approximately 53.0% of PWH had a PDC ≥ 0.95, 30.2% had a PDC between 0.70 and < 0.95, and 16.8% had PDC < 0.70. Treatment gaps of at least ≥ 7-days (55.2%) and ≥ 30-days (26.2%) were common and 10.1% PWH discontinued treatment. Younger age, female sex, Black race, higher comorbidity score, mental health conditions, and substance use disorder were associated with higher odds of lower adherence and discontinuation (all p-values < 0.05). In conclusion, suboptimal adherence and treatment gaps in ART use were commonly observed among PWH in Medicare. Interventions and policies to mitigate barriers to adherence are urgently needed in this population to both improve their survival and increase the potential for ending the HIV epidemic in the US.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.