| Potential Risk Factors of Low Adherence | Low Adherence Based on PDC at 12 Months PDC < 80%a (n = 1,780) | |||||||
|---|---|---|---|---|---|---|---|---|
| PDC < 80% (n = 1,176) | PDC ≥ 80% (n = 604) | 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 | 123 (10.5) | 63 (10.4) | 1.00 | (0.71-1.42) | 0.990 | 1.45 | (0.99-2.11) | 0.057 |
| 30-49 | 640 (54.4) | 329 (54.5) | 1.00 | (0.81-1.23) | 0.989 | 1.09 | (0.86-1.39) | 0.483 |
| ≥ 50 | 413 (35.1) | 212 (35.1) | 1.00 | – | – | 1.00 | – | – |
| Female (reference: male) | 392 (33.3) | 246 (40.7) | 0.73 | (0.59-0.89) | 0.002c | 1.04 | (0.83-1.31) | 0.744 |
| Race (reference: black) | ||||||||
| White | 438 (37.2) | 167 (27.6) | 1.48 | (1.18-1.85) | <0.001c | 1.05 | (0.81-1.38) | 0.697 |
| Black | 599 (50.9) | 338 (56.0) | 1.00 | – | – | 1.00 | (1.00-1.00) | – |
| Otherd | 139 (11.8) | 99 (16.4) | 0.79 | (0.59-1.06) | 0.116 | 1.00 | (0.72-1.39) | 0.978 |
| Region characteristics (reference: suburban/rural) | ||||||||
| Suburban/rural | 472 (40.1) | 222 (36.8) | 1.00 | – | – | 1.00 | – | – |
| Urban | 704 (59.9) | 382 (63.2) | 0.87 | (0.71-1.06) | 0.166 | 1.15 | (0.88-1.51) | 0.300 |
| No capitated insurance eligibilitye | 671 (57.1) | 310 (51.3) | 1.26 | (1.03-1.53) | 0.021c | 0.90 | (0.70-1.16) | 0.402 |
| Dual Medicaid/Medicare coverage insurance eligibility | 396 (33.7) | 22 (3.6) | 13.42 | (8.62-20.90) | <0.001c | 14.35 | (8.90-23.16) | < 0.001c |
| Year of index date (reference: 2014 or after) | ||||||||
| Before 2014 | 956 (81.3) | 501 (82.9) | 0.89 | (0.69-1.16) | 0.391 | 1.06 | (0.77-1.47) | 0.720 |
| 2014 or after | 220 (18.7) | 103 (17.1) | 1.00 | – | – | 1.00 | – | – |
| No prior ARV medication usef,g | 973 (82.7) | 414 (68.5) | 2.20 | (1.75-2.77) | <0.001c | 1.73 | (1.34-2.23) | < 0.001c |
| CCI score (excluding HIV symptoms)f | ||||||||
| 0 | 813 (69.1) | 394 (65.2) | 1.69 | (1.13-2.50) | 0.010c | 1.41 | (0.78-2.55) | 0.258 |
| 1 | 204 (17.3) | 106 (17.5) | 1.57 (1.01-2.45) | 0.046c | 1.22 | (0.71-2.10) | 0.469 | |
| 2 | 99 (8.4) | 55 (9.1) | 1.47 | (0.89-2.43) | 0.132 | 1.22 | (0.67-2.22) | 0.507 |
| ≥ 3 | 60 (5.1) | 49 (8.1) | 1.00 | – | – | 1.00 | – | – |
| Comorbidities | ||||||||
| Chronic pulmonary disease | 151 (12.8) | 96 (15.9) | 0.78 | (0.59-1.03) | 0.078 | 1.05 | (0.70-1.56) | 0.827 |
| Diabetes | 100 (8.5) | 60 (9.9) | 0.84 | (0.60-1.18) | 0.318 | 0.90 | (0.57-1.43) | 0.663 |
| Hypertension | 227 (19.3) | 130 (21.5) | 0.87 | (0.68-1.11) | 0.268 | 0.95 | (0.69-1.30) | 0.730 |
| Psychoses | 173 (14.7) | 99 (16.4) | 0.88 | (0.67-1.15) | 0.351 | 0.81 | (0.55-1.18) | 0.269 |
| Substance-related and addictive disorders | 182 (15.5) | 118 (19.5) | 0.75 | (0.58-0.97) | 0.031c | 1.04 | (0.76-1.41) | 0.824 |
| Any mental comorbidity excluding substance-related and addictive disorders | 313 (26.6) | 181 (30.0) | 0.85 | (0.68-1.05) | 0.135 | 0.93 | (0.68-1.27) | 0.652 |
| No HIV symptomsh | 409 (34.8) | 198 (32.8) | 1.09 | (0.89-1.35) | 0.400 | 1.48 | (1.14-1.91) | 0.003c |
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 the 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.