44% of Medicaid enrollees do not reinitiate HIV treatment after discontinuation
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Many Medicaid enrollees with HIV do not reinitiate ART after discontinuing their treatment, according to study findings. Researchers found that, during a 12-year period, 44% failed to reinitiate treatment within 18 months, and that engagement in care was significantly associated with patients resuming treatment.
“Although it is well known that adherence to HIV drug therapy is critical in maintaining the health of people living with HIV, it is challenging to have long-term good adherence to HIV treatment,” Tingting Zhang, PhD, assistant professor of health services polic and practice at Brown University, told Healio. “We do not know whether or when people with HIV reinitiate their treatment after they discontinue their therapy or which individual characteristics are associated with reinitiation in a publicly insured population with HIV.”
In a retrospective cohort study, Zhang and colleagues explored the association between personal characteristics and time from ART discontinuation reinitiation within 18 months among Medicaid enrollees between 2001 and 2012. According to the researchers, it was the first national study to examine rates and predictors of HIV treatment re-initiation after interruption.
Of the 103,885 enrollees included in the study, 45,409 discontinued ART, with 44% not reinitiating. Researchers cited younger age, being a woman, having two or more non-HIV physical comorbidities and presence of a mental health comorbidity as factors associated with not reinitiating.
Among those who did reinitiate ART, the median time between discontinuation to reinitiation was 8.2 months. Researchers found that three or more outpatient visits and hospitalization during follow-up were associated with reinitiation.
“In this national study, nearly half of people living with HIV did not reinitiate HIV treatment within 18 months following a discontinuation,” Zhang said. “This long treatment gap could result in negative health outcomes and increased HIV transmission rates. There is a need to develop clinical interventions that focus on young patients and women, and re-engaging and retaining such people in care.” – by Caitlyn Stulpin
Disclosures: Zhang reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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