Background: People with HIV (PWH) use various pharmacy types beyond traditional local pharmacies. Some specialized pharmacies offer additive adherence services such as refill reminders, expedited delivery, and adherence packaging.
Methods: This single-center, retrospective cohort study evaluated the impact of pharmacy type on the gain or loss of HIV viral suppression (VS; HIV RNA ≤50 copies/mL). Patients (≥19 years) were categorized by VS and pharmacy type: HIV-specialized (additive adherence/delivery services) vs traditional (without adherence/delivery services). Fisher exact tests examined the effect of pharmacy type on differences in VS between years, and logistic regression models identified possible predictors of gaining or losing VS.
Results: During 2017-2018, no differences were observed for the gain or loss of VS across pharmacy types (VS gain vs continued viremia, = .393; VS loss vs continued VS, = .064). Predictors for the gain of VS included antiretroviral therapy adherence as percentage of days covered (PDC; adjusted odds ratio [aOR], 1.05; < .001) and Federal Poverty Level 100%-138% (FPL; aOR, 0.17; = .032). Predictors for the loss of VS included use of protease inhibitor (aOR, 2.85; = .013), ≥1 other illicit substance including tobacco (aOR, 2.96; = .024), PDC (aOR, 0.95; < .001), FPL 139%-200% (aOR, 0.09; = .031), and CD4 >200 cells/ccm (aOR, 0.19; = .013).
Conclusions: The gain or loss of VS among PWH in this retrospective cohort was not impacted by pharmacy transitions within the 2-year study period. However, PDC, FPL, illicit substance use, protease inhibitor use, and CD4 >200 cells/ccm were identified as factors associated with changes in VS.
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| http://dx.doi.org/10.1093/ofid/ofaa351 | DOI Listing |
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