ART Use Rises Among US Medicare Enrollees Living With HIV

TOPLINE: 

Antiretroviral therapy (ART) prescription rates among Medicare enrollees living with HIV increased from 2007 to 2019. Although age-based disparities had reduced, women and both younger and older people had lower ART rates.

METHODOLOGY:

• Since 2012, the US Department of Health and Human services advised initiating ART for all people living with HIV, regardless of their cluster of differentiation 4 T cell count, and as quickly as possible after diagnosis.
• Researchers evaluated ART prescription trends among Medicare beneficiaries living with HIV in the United States between 2007 and 2019. Data were obtained from the Medicare database incorporated with the Master Beneficiary Summary files and Part D files.
• A total of 249,643 Medicare enrollees (mean age, 52.7 years; 70.7% men) with at least one diagnosis of HIV on an inpatient claim or two other claims made during the 2-year reference period were included.
• Patients were stratified by age (

TAKEAWAY:

• The proportion of patients receiving ART increased from 2007 to 2019, with most age groups showing over 80% ART utilization by 2019. In the same year, the highest prescription rates were observed among people living with HIV aged 50-64 years (95% men; 92% women).
• Compared with men, women younger than 65 years were 35% less likely (odds ratio [OR], 0.65; 95% CI, 0.60-0.70) to enroll for ART.
• People in the youngest (18-29 vs 50-64 years: OR, 0.43; 95% CI, 0.34-0.54) and the oldest (≥ 80 vs 65-69 years: OR, 0.34; 95% CI, 0.30-0.39) age groups were less likely to receive ART.
• Older people living with HIV, who also had Alzheimer’s disease and related dementia and those living in rural and nonmetro regions were less likely to receive ART.

IN PRACTICE:

“Increasing ART use with reductions in disparities over time is encouraging and likely reflects the introduction of ART with fewer side effects and drug interactions and the embracing of recommendations for universal ART,” the authors wrote.

SOURCE:

This study was led by Xiaoying Yu, PhD, University of Texas Medical Branch at Galveston, Galveston, Texas. It was published online on November 25, 2024, in HIV Medicine.

LIMITATIONS:

People living with HIV who could receive ART outside Medicare were not included. The analysis used claims-based diagnoses that lacked detailed clinical, psychological, or behavioral information that could account for confounding factors. Lastly, as this study used a binary definition of sex, the transgender population could not be studied.

DISCLOSURES:

This study was supported by the National Institutes of Health/Office of the Director, National Institute of Allergy and Infectious Diseases, and Eunice Kennedy Shriver National Institute of Child Health and Human Development. No conflicts of interest were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.