Table 2.
Factors Associated With Switching from Tenofovir Disoproxil Fumarate/Emtricitabine to Tenofovir Alafenamide/Emtricitabine, Fenway Health, 1 October 2019–30 September 2020
| Factor | Did Not Switch to TAF/FTC | Switched to TAF/FTC | Unadjusted HR (95% CI) | Age-Adjusted HR (95% CI) |
|---|---|---|---|---|
| No. (row %) | 2549 (88.1) | 343 (11.9) | … | … |
| Age, y | ||||
| <30 | 658 (90.3) | 71 (9.7) | ref | … |
| 30–39 | 960 (89.1) | 117 (10.9) | 1.1 (.8–1.5) | … |
| 40–49 | 471 (88.0) | 64 (12.0) | 1.2 (.9–1.7) | … |
| 50–59 | 354 (85.9) | 58 (14.1) | 1.5 (1.0–2.1) | … |
| ≥60 | 106 (76.3) | 33 (23.7) | 2.6 (1.7–3.8) | … |
| Gender | ||||
| Cisgender man | 2445 (88.1) | 329 (11.9) | ref | ref |
| Transgender woman | 36 (85.7) | 6 (14.3) | 1.2 (.5–2.6) | 1.4 (.6–3.1) |
| Another gender | 34 (85.0) | 6 (15.0) | 1.3 (.6–2.9) | 1.4 (.6–3.0) |
| Nonbinary | 32 (94.1) | 2 (5.9) | 0.5 (.1–1.9) | 0.6 (.1–2.4) |
| Race | ||||
| White | 1865 (88.5) | 243 (11.5) | ref | ref |
| Black or African American | 144 (86.2) | 23 (13.8) | 1.2 (.8–1.9) | 1.3 (.9–2.1) |
| Multiracial | 143 (87.7) | 20 (12.3) | 1.1 (.7–1.7) | 1.2 (.7–1.9) |
| Asian | 134 (87.6) | 19 (12.4) | 1.1 (.7–1.7) | 1.2 (.8–2.0) |
| Another race | 45 (86.5) | 7 (13.5) | 1.2 (.6–2.6) | 1.3 (.6–2.8) |
| Native Hawaiian or other Pacific Islander | 15 (93.8) | 1 (6.3) | 0.5 (.1–4.0) | 0.5 (.1–3.9) |
| American Indian or Alaska Native | 14 (100.0) | 0 (0.0) | … | … |
| Ethnicity | ||||
| Not Hispanic | 1990 (89.0) | 246 (11.0) | ref | ref |
| Hispanic | 332 (85.6) | 56 (14.4) | 1.4 (1.0–1.8) | 1.4 (1.1–1.9) |
| Insurance | ||||
| Private | 2154 (88.3) | 285 (11.7) | ref | ref |
| Medicaid | 254 (87.6) | 36 (12.4) | 1.1 (.8–1.5) | 1.1 (.8–1.5) |
| Medicare | 47 (77.1) | 14 (23.0) | 2.0 (1.2–3.4) | 1.5 (.9–2.6) |
| Uninsured | 43 (87.8) | 6 (12.2) | 1.0 (.5–2.3) | 1.1 (.5–2.4) |
| Other public | 45 (95.7) | 2 (4.3) | 0.4 (.1–1.4) | 0.4 (.1–1.4) |
| STI diagnosisa | ||||
| No | 2187 (88.5) | 285 (11.5) | ref | ref |
| Yes | 362 (86.2) | 58 (13.8) | 1.2 (.9–1.6) | 1.3 (1.0–1.7) |
| Reduced bone densityb | ||||
| No | 2536 (88.2) | 340 (11.8) | ref | ref |
| Yes | 13 (81.3) | 3 (18.8) | 1.6 (.5–5.0) | 1.4 (.5–4.1) |
| Hypertensionb | ||||
| No | 2277 (88.8) | 288 (11.2) | ref | ref |
| Yes | 272 (83.2) | 55 (16.8) | 1.6 (1.2–2.1) | 1.3 (1.0–1.8) |
| Diabetes mellitusb | ||||
| No | 2482 (88.5) | 322 (11.5) | ref | ref |
| Yes | 67 (76.1) | 21 (23.9) | 2.2 (1.4–3.3) | 1.8 (1.1–2.8) |
| BMIc, kg/m2 | ||||
| <18.5 | 20 (95.2) | 1 (4.8) | 0.4 (.1–3.0) | 0.5 (.1–3.7) |
| 18.5–24.9 | 905 (88.0) | 123 (12.0) | 1.1 (.8–1.5) | 1.2 (.9–1.7) |
| 25.0–29.9 | 839 (86.3) | 133 (13.7) | 1.3 (.9–1.8) | 1.3 (.9–1.8) |
| ≥30.0 | 439 (89.2) | 53 (10.8) | ref | ref |
| CrCld, mL/min | ||||
| <60 | 22 (50.0) | 22 (50.0) | 5.2 (3.5–7.9) | 4.3 (2.7–6.8) |
| ≥60 | 2102 (88.1) | 283 (11.9) | ref | ref |
| Total cholesterold, mg/dL | ||||
| <180 | 450 (84.4) | 83 (15.6) | ref | ref |
| 180–199 | 199 (89.6) | 23 (10.4) | 0.7 (.4–1.0) | 0.7 (.4–1.0) |
| ≥200 | 199 (93.0) | 15 (7.0) | 0.4 (.2–.7) | 0.4 (.2–.7) |
| LDL-cd, mg/dL | ||||
| ≤100 | 384 (82.2) | 83 (17.8) | ref | ref |
| 101–160 | 426 (88.6) | 55 (11.4) | 0.6 (.4–.9) | 0.6 (.4–.9) |
| >160 | 38 (84.4) | 7 (15.6) | 0.9 (.4–1.9) | 0.9 (.4–1.9) |
| HDL-cd, mg/dL | ||||
| <40 | 233 (87.9) | 32 (12.1) | ref | ref |
| 40–59 | 450 (86.0) | 73 (14.0) | 1.2 (.8–1.8) | 1.2 (.8–1.9) |
| ≥60 | 163 (91.6) | 15 (8.4) | 0.7 (.4–1.3) | 0.7 (.4–1.3) |
Data are presented as No. (%) unless otherwise indicated. Values in bold indicate P < .05. Missing data were <0.1% for gender, 7.6% for race, 9.3% for ethnicity, 0.2% for insurance, 13.1% for BMI, 16.0% for CrCl, and 66.5% for lipids.
Abbreviations: BMI, body mass index; CI, confidence interval; CrCl, creatinine clearance; HDL-c, high-density lipoprotein cholesterol; HR, hazard ratio; LDL-c, low-density lipoprotein cholesterol; STI, sexually transmitted infection; TAF/FTC, tenofovir alafenamide with emtricitabine.
aSTI diagnosis included syphilis, gonorrhea, or chlamydia in the 12 months prior to October 2019.
bReduced bone density, hypertension, and diabetes mellitus were based on any diagnoses prior to October 2019.
cBMI was based on the most recent body weight and height prior to October 2019.
dCreatinine and lipids were the most recent in the 12 months prior to October 2019.