Table 3. Prevalence of Study Outcomes Among People Living With HIV in 24 Countriesa, With or Without a Report of Polypharmacyb, Stratified by Self-Reported Virologic Control Statusc, Positive Perspectives Study, 2019.
| Outcome | Medication-Count–Based Measure of Polypharmacy |
Proxy Measure of Polypharmacy |
|||
|---|---|---|---|---|---|
| Prevalence of Outcome Among Those Reporting Polypharmacy (n = 884), % | Prevalence of Outcome Among Those Not Reporting Polypharmacy (n = 1,218), % | Associations With Polypharmacy and Outcome, AOR (95% CI)d | Associations Between Perceived Overmedication and Outcome, AOR (95% CI)d | Associations Between Cut-Down Attempt and Outcome, AOR (95% CI)d | |
| All participants (N = 2,112) | |||||
| Self-rated overall health | 46.6 | 62.6 | 0.64 (0.53–0.78)e | 0.66 (0.55–0.80)e | 0.66 (0.54–0.80)e |
| Self-rated mental health | 46.9 | 62.9 | 0.58 (0.48–0.71)e | 0.84 (0.70–1.01) | 0.50 (0.42–0.61)e |
| Self-rated sexual health | 36.2 | 54.5 | 0.63 (0.52–0.77)e | 0.69 (0.58–0.83)e | 0.57 (0.47–0.69)e |
| Self-rated physical health | 44.7 | 68.1 | 0.49 (0.40–0.60)e | 0.95 (0.79–1.14) | 0.62 (0.51–0.76)e |
| Treatment satisfaction | 65.2 | 73.1 | 0.73 (0.59–0.91)e | 0.72 (0.59–0.87)e | 0.57 (0.47–0.70)e |
| Met treatment needs | 68.7 | 68.5 | 0.96 (0.78–1.18) | 0.74 (0.61–0.89)e | 0.68 (0.55–0.83)e |
| Positive outlook for longevity | 42.5 | 49.8 | 0.85 (0.70–1.04) | 0.38 (0.31–0.46)e | 0.47 (0.39–0.57)e |
| Reporting virologic suppression (n = 1,536) | |||||
| Self-rated overall health | 48.7 | 65.0 | 0.65 (0.51–0.83)e | 0.61 (0.49–0.76)e | 0.74 (0.59–0.93)e |
| Self-rated mental health | 53.9 | 63.1 | 0.75 (0.59–0.95)e | 0.72 (0.58–0.89)e | 0.55 (0.44–0.68)e |
| Self-rated sexual health | 38.6 | 55.0 | 0.75 (0.59–0.95)e | 0.61 (0.49–0.75)e | 0.60 (0.48–0.75)e |
| Self-rated physical health | 49.0 | 71.5 | 0.53 (0.42–0.68)e | 0.75 (0.60–0.93)e | 0.68 (0.54–0.86)e |
| Treatment satisfaction | 69.5 | 73.5 | 0.75 (0.58–0.98)e | 0.67 (0.53–0.85)e | 0.52 (0.41–0.66)e |
| Met treatment needs | 72.2 | 68.1 | 1.05 (0.81–1.36) | 0.65 (0.52–0.82)e | 0.74 (0.58–0.94)e |
| Positive outlook for longevity | 49.5 | 56.1 | 0.93 (0.74–1.18) | 0.37 (0.30–0.45)e | 0.56 (0.45–0.70)e |
| Not reporting virologic suppression (n = 576) | |||||
| Self-rated overall health | 41.8 | 55.4 | 0.73 (0.50–1.07) | 0.75 (0.52–1.09) | 0.59 (0.40–0.87)e |
| Self-rated mental health | 31.0 | 62.3 | 0.37 (0.25–0.54)e | 1.35 (0.93–1.98) | 0.48 (0.32–0.71)e |
| Self-rated sexual health | 30.6 | 53.1 | 0.44 (0.29–0.66)e | 0.88 (0.60–1.30) | 0.54 (0.36–0.82)e |
| Self-rated physical health | 34.7 | 57.7 | 0.48 (0.32–0.70)e | 1.62 (1.11–2.36)e | 0.61 (0.41–0.90)e |
| Treatment satisfaction | 55.2 | 71.8 | 0.63 (0.43–0.94)e | 0.92 (0.62–1.36) | 0.73 (0.48–1.11) |
| Met treatment needs | 60.4 | 69.5 | 0.70 (0.47–1.04) | 0.99 (0.67–1.45) | 0.51 (0.34–0.78)e |
| Positive outlook for longevity | 26.5 | 30.8 | 0.94 (0.62–1.42) | 0.26 (0.17–0.41)e | 0.31 (0.21–0.48)e |
Abbreviations: AOR, adjusted odds ratio; CI, confidence interval.
Countries included in study were Argentina, Austria, Australia, Belgium, Brazil, Canada, Chile, China, France, Germany, Ireland, Italy, Japan, Mexico, Netherlands, Poland, Portugal, Russia, South Korea, Spain, Switzerland, Taiwan, United Kingdom, and United States.
Polypharmacy was defined as taking 5 or more pills per day for HIV or non-HIV conditions or taking medicines currently for 5 or more conditions, including HIV/AIDS. For the cognitive proxy (perceived overmedication), we used a set of 6 questions that assessed respondents’ anxieties regarding short-, medium-, and long-term effects from their current HIV medicines, including worries about long-term side effects, having to take increasingly more medicines, potential interactions with other medications, impact on body and/or body shape, impact on overall health and well-being, and unknown long-term impact. Being worried about at least 5 of these items was subjectively classified as acute awareness on the part of the respondent of the number of medicines they were taking. For the behavioral proxy (cut-down attempt), participants were classified as having taken deliberate efforts to reduce the number/impact of medicines they were taking if they skipped taking their HIV medicines in the past 30 days because they were concerned about short- or long-term side effects of medicines or if they completely switched medicines to reduce the number of medicines taken.
Self-reported virologic suppression was defined as a response of “undetectable” or “suppressed” versus “detectable,” “unsuppressed,” “I don’t know,” or “prefer not to say” to the question, “What is your most recent viral load?”
Adjusted odds ratios for the different outcomes were computed in separate logistic regression models, controlling for age, duration of disease, geographic region, comorbidities, urbanicity, education, and sexual orientation.
Significant at P < .05.