TABLE 3.
Risk Factors of Poor Adherence (Based on the PDC at 6 Months) Using a Logistic Regression Model
| Potential Risk Factors of Poor Adherence | Poor Adherence Based on PDC at 6 Months PDC < 80%a (n = 2,683) | |||||||
|---|---|---|---|---|---|---|---|---|
| PDC < 80% (n = 1,370) | PDC ≥ 80% (n = 1,313) | Univariable Logistic Model | Multivariable Logistic Modelb | |||||
| n (%) | n (%) | OR | (95% CI) | P Value | OR | (95% CI) | P Value | |
| Age categories, years (reference: ≥ 50 years) | ||||||||
| 18-29 | 172 (12.6) | 131 (10.0) | 1.27 | (0.98-1.65) | 0.074 | 1.58 | (1.18-2.11) | 0.002c |
| 30-49 | 722 (52.7) | 722 (55.0) | 0.97 | (0.82-1.14) | 0.684 | 0.96 | (0.80-1.16) | 0.690 |
| ≥ 50 | 476 (34.7) | 460 (35.0) | 1.00 | – | – | 1.00 | – | – |
| Female (reference: male) | 495 (36.1) | 564 (43.0) | 0.75 | (0.64-0.88) | < 0.001c | 1.10 | (0.92-1.32) | 0.291 |
| Race (reference: black) | ||||||||
| White | 476 (34.7) | 318 (24.2) | 1.57 | (1.32-1.87) | < 0.001c | 1.14 | (0.93-1.40) | 0.212 |
| Black | 723 (52.8) | 758 (57.7) | 1.00 | – | – | 1.00 | – | – |
| Otherd | 171 (12.5) | 237 (18.1) | 0.76 | (0.61-0.94) | 0.014c | 1.00 | (0.78-1.28) | 0.976 |
| Region characteristics (reference: suburban/rural) | ||||||||
| Suburban/rural | 547 (39.9) | 394 (30.0) | 1.00 | – | – | 1.00 | – | – |
| Urban | 823 (60.1) | 919 (70.0) | 0.65 | (0.55-0.76) | < 0.001c | 1.00 | (0.81-1.24) | 0.995 |
| No capitated insurance eligibility | 795 (58.0) | 582 (44.3) | 1.74 | (1.49-2.02) | < 0.001c | 1.40 | (1.16-1.69) | < 0.001c |
| Dual coverage insurance eligibilitye | 392 (28.6) | 69 (5.3) | 7.22 | (5.52-9.46) | < 0.001c | 5.98 | (4.39-8.16) | < 0.001c |
| Year of index date (reference: 2014 or after) | ||||||||
| Before 2014 | 1,071 (78.2) | 1,067 (81.3) | 0.83 | (0.68-1.00) | 0.047c | 1.20 | (0.96-1.51) | 0.117 |
| 2014 or after | 299 (21.8) | 246 (18.7) | 1.00 | – | – | 1.00 | (1.00-1.00) | – |
| No prior ARV medication usef,g | 1,129 (82.4) | 862 (65.7) | 2.45 | (2.05-2.93) | < 0.001c | 1.98 | (1.62-2.41) | < 0.001c |
| CCI score (excluding HIV symptoms)f | ||||||||
| 0 | 948 (69.2) | 863 (65.7) | 1.33 | (0.98-1.80) | 0.063 | 1.12 | (0.71-1.78) | 0.624 |
| 1 | 238 (17.4) | 219 (16.7) | 1.32 | (0.94-1.85) | 0.113 | 1.03 | (0.68-1.55) | 0.887 |
| 2 | 99 (7.2) | 128 (9.7) | 0.94 | (0.64-1.38) | 0.744 | 0.76 | (0.48-1.20) | 0.240 |
| ≥ 3 | 85 (6.2) | 103 (7.8) | 1.00 | – | – | 1.00 | – | – |
| Comorbidities | ||||||||
| Chronic pulmonary disease | 191 (13.9) | 217 (16.5) | 0.82 | (0.66-1.01) | 0.063 | 1.17 | (0.86-1.61) | 0.323 |
| Diabetes | 124 (9.1) | 122 (9.3) | 0.97 | (0.75-1.26) | 0.829 | 1.18 | (0.83-1.68) | 0.358 |
| Hypertension | 274 (20.0) | 297 (22.6) | 0.86 | (0.71-1.03) | 0.098 | 1.02 | (0.80-1.30) | 0.877 |
| Psychoses | 216 (15.8) | 210 (16.0) | 0.98 | (0.80-1.21) | 0.872 | 0.96 | (0.72-1.28) | 0.768 |
| Substance-related and addictive disorders | 219 (16.0) | 259 (19.7) | 0.77 | (0.64-0.94) | 0.012c | 1.12 | (0.89-1.43) | 0.336 |
| Any mental comorbidity excluding substance-related and addictive disorders | 384 (28.0) | 413 (31.5) | 0.85 | (0.72-1.00) | 0.052 | 0.92 | (0.72-1.17) | 0.485 |
| No HIV symptomsf,h | 493 (36.0) | 433 (33.0) | 1.14 | (0.97-1.34) | 0.102 | 1.37 | (1.13-1.68) | 0.002c |
aIncludes patients with ≥ 6 months of observation period.
bThe states were included in the model as a controlling factor.
cIndicates that P < 0.05.
dIncludes Hispanic, other, and unknown races.
eRefers to insurance coverage by both Medicaid and Medicare.
fAssessed within the 6-month baseline period.
gThe count excluded boosting agents (ritonavir and cobicistat).
hPatients with no diagnosis code for HIV with symptoms, identified using ICD-9-CM diagnosis code 042. Of note, asymptomatic HIV corresponds to the ICD-9-CM code V08.
ARV = antiretroviral; CCI = Charlson Comorbidity Index; CI = confidence interval; HIV = human immunodeficiency virus; ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; OR = odds ratio; PDC = proportion of days covered.