Table 3.
Viral Suppression of Virginia AIDS Drug Assistance Program (ADAP) Clients With Qualified Health Plan (QHP) Coverage and ADAP Clients Who Were Eligible for ADAP-Funded QHP Coverage but Did Not Enroll
| Characteristic | Denominator, No. (%) | Enrollment, % | Good Virologic Outcome, % | OR (95% CI) | P Value | Adjusted OR (95% CI) | P Value |
|---|---|---|---|---|---|---|---|
| All | 2163 | 53.5 | 81.8 | ||||
| ACA marketplace status | <.001 | .02 | |||||
| QHP Coverage | 1157 (53.5) | 100.0 | 84.6 | 1.495 (1.200–1.862) | 1.346 (1.041–1.740) | ||
| Not enrolled/Direct ADAP | 1006 (46.5) | 0.0 | 78.6 | Reference | Reference | ||
| Initial virologic status (2013) | <.001 | <.001 | |||||
| Undetectable | 1552 (71.8) | 55.9 | 87.8 | 3.615 (2.881–4.535) | 2.809 (2.174–3.636) | ||
| Detectable | 611 (28.2) | 47.5 | 66.6 | Reference | Reference | ||
| Days observed | … | … | … | 1.003 (1.001–1.004) | <.001 | 1.001 (1.000–1.003) | .07 |
| Age, y | .001 | .28 | |||||
| 18–24 | 130 (6.0) | 56.2 | 71.5 | 0.351 (.210–.586) | 0.554 (.308–.995) | ||
| 25–34 | 391 (18.1) | 51.9 | 78.8 | 0.518 (.340–.789) | 0.642 (.402–1.026) | ||
| 35–44 | 541 (25.0) | 50.3 | 83.0 | 0.681 (.452–1.027) | 0.713 (.454–1.121) | ||
| 45–54 | 799 (36.9) | 55.1 | 82.0 | 0.635 (.431–.937) | 0.662 (.432–1.013) | ||
| 55–64 | 302 (24.1) | 62.6 | 84.9 | Reference | Reference | ||
| Race/ethnicity | .01 | .10 | |||||
| American Indian/Alaska Native/Native Hawaiian | 17 (0.8) | 58.8 | 88.2 | 1.337 (.300–5.962) | 4.320 (.857–21.788) | ||
| Asian | 37 (1.7) | 54.1 | 89.2 | 1.471 (.507–4.267) | 0.691 (.204–2.338) | ||
| Black/African American | 1412 (65.3) | 50.3 | 79.6 | 0.696 (.530–.914) | 0.773 (.560–1.067) | ||
| Hispanic/Latino | 175 (8.1) | 51.4 | 88.6 | 1.382 (.819–2.333) | 1.090 (.591–2.011) | ||
| White | 522 (24.1) | 62.6 | 84.9 | Reference | Reference | ||
| Sex | .77 | .78 | |||||
| Female | 639 (29.5) | 52.3 | 81.7 | 0.983 (.774–1.249) | 0.907 (.689–1.175) | ||
| Transgender | 7 (0.3) | 42.9 | 71.4 | 0.551 (.106–2.855) | 1.088 (.119–9.940) | ||
| Male | 1517 (70.1) | 54.1 | 81.9 | Reference | Reference | ||
| HIV/AIDS Diagnosis | .58 | .02 | |||||
| AIDS Diagnosis | 1287 (59.5) | 52.2 | 82.2 | 1.064 (.853–1.328) | 1.377 (1.049–1.808) | ||
| HIV diagnosis | 876 (40.5) | 50.9 | 81.3 | Reference | Reference | ||
| Previous ADAP plan (2013) | .10 | .61 | |||||
| PCIP | 141 (6.5) | 73.8 | 76.6 | 0.709 (.472–1.064) | 0.882 (.543–1.433) | ||
| Direct ADAP | 2022 (93.5) | 52.1 | 82.2 | Reference | Reference | ||
| Financial status | .97 | .53 | |||||
| 251%–400% FPL (tax credit) | 138 (6.4) | 50.7 | 82.6 | 1.160 (.732–1.837) | 0.814 (.486–1.364) | ||
| 139%–250% FPL (tax credit) | 376 (17.4) | 59.3 | 84.0 | 1.286 (.947–1.747) | 1.032 (.728–1.462) | ||
| 101%–138% FPL (Medicaid gap with tax credit) | 258 (11.9) | 58.5 | 86.0 | 1.506 (1.034–2.194) | 1.285 (.844–1.957) | ||
| <100% FPL (Medicaid gap, no tax credit) | 1391 (64.3) | 51.3 | 80.4 | Reference | Reference | ||
| Virginia region of residence | <.001 | .46 | |||||
| Northwest | 220 (10.2) | 68.6 | 91.8 | 1.091 (.623–1.909) | 1.756 (.667–4.619) | ||
| Eastern | 439 (20.3) | 54.2 | 60.8 | .151 (0107–.213) | 1.097 (.389–3.095) | ||
| Central | 681 (31.5) | 50.2 | 84.6 | 0.533 (.375–.759) | 1.222 (.483–3.091) | ||
| Southwest | 236 (10.9) | 49.2 | 80.5 | 0.401 (.261–.617) | 0.658 (.226–1.920) | ||
| Northern | 587 (27.1) | 52.8 | 91.1 | Reference | Reference | ||
| HIV clinic | … | … | … | … | <.001 | … | <.001 |
Abbreviations: ACA, Affordable Care Act; ADAP, AIDS Drug Assistance Program; CI, confidence interval; FPL, federal poverty level; HIV, human immunodeficiency virus; OR, odds ratio; PCIP, Pre-existing Condition Insurance Plan; QHP, qualified health plan.