Background: Since 1996, introduction of protease inhibitors (PI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) has led to dramatic improvements in health status and survival among persons with HIV. However, prior work suggests that access to antiretrovirals is uneven across subgroups. This may be the case even among individuals with the same pharmacy coverage (e.g., Medicaid beneficiaries). In addition to incidence of therapy, a key issue is whether use is continued over time to the same extent across subgroups (persistence of treatment).
Methods:, We analyzed pharmacy claims histories for 1996, 1997 and 1998 for 2,459 New Jersey non-HMO Medicaid beneficiaries with AIDS age 18+, identified through matching between the AIDS Registry and Medicaid files by the New Jersey Department of Health, which provided a research file with deidentified claims histories.
Results: In multivariate analyses, the proportion with any PI/NNRTI use was lower among African Americans and Hispanics, and higher among participants in a case-managed Medicaid waiver program and those with dual Medicare eligibility. Despite some convergence by 1998, significant differences remained. Among those with any PI/NNRTI use, the proportion of observation time with PI/NNRTI use was lower for African Americans, Hispanics, and those under age 30, and higher for waiver and Medicare participants.
Discussion: Despite having comparable pharmacy coverage, subgroups of the Medicaid AIDS population varied substantially both in incidence and in persistence of PI/NNRTI use, suggesting the need to examine other barriers to access to care and to the ability to consistently remain on these highly efficacious regimens.
Learning Objectives: At the conclusion of this session, participants will have increased understanding of key access issues and research findings relating to use of highly active antiretroviral therapies in HIV/AIDS
Keywords: HIV/AIDS, Access and Services
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.