Increase in single-tablet regimen use and associated improvements in adherence-related outcomes in HIV-Infected Women

David B. Hanna, Nancy A. Hessol, Elizabeth Golub, Jennifer M. Cocohoba, Mardge H. Cohen, Alexandra M. Levine, Tracey E. Wilson, Mary Young, Kathryn Anastos, Robert C. Kaplan

Research output: Contribution to journalArticle

Abstract

Introduction: The use of single-tablet antiretroviral therapy (ART) regimens and its implications on adherence among HIV-infected women have not been well described. Methods: Participants were enrolled in the Women's Interagency HIV Study, a longitudinal study of HIV infection in US women. We examined semiannual trends in single-tablet regimen use and ART adherence, defined as self-reported 95% adherence in the past 6 months, during 2006-2013. In a nested cohort study, we assessed the comparative effectiveness of a single-tablet versus a multiple-tablet regimen with respect to adherence, virologic suppression, quality of life, and AIDS-defining events, using propensity score matching to account for demographic, behavioral, and clinical confounders. We also examined these outcomes in a subset of women switching from a multiple- to single-tablet regimen using a case-crossover design. Results: We included 15,523 person-visits, representing 1727 women (53% black, 29% Hispanic, 25% IDU, median age 47). Use of single-tablet regimens among ART users increased from 7% in 2006% to 27% in 2013; adherence increased from 78% to 85% during the same period (both P , 0.001). Single-tablet regimen use was significantly associated with increased adherence (adjusted risk ratio: 1.05; 95% confidence interval: 1.03 to 1.08) and virologic suppression (risk ratio: 1.06; 95% confidence interval: 1.01 to 1.11), while associations with improved quality of life and fewer AIDS-defining events did not achieve statistical significance. Similar findings were observed among the subset of switchers. Conclusions: Single-tablet regimen use was associated with increased adherence and virologic suppression. Despite this, 15% of women prescribed ART were still not optimally adherent; additional interventions are needed to maximize therapeutic benefits.

Original languageEnglish (US)
Pages (from-to)587-596
Number of pages10
JournalJournal of Acquired Immune Deficiency Syndromes
Volume65
Issue number5
DOIs
StatePublished - Apr 15 2014

Fingerprint

Tablets
HIV
Acquired Immunodeficiency Syndrome
Odds Ratio
Quality of Life
Confidence Intervals
Therapeutics
Propensity Score
Hispanic Americans
Cross-Over Studies
HIV Infections
Longitudinal Studies
Cohort Studies
Demography

Keywords

  • Adherence
  • Antiretroviral therapy
  • HIV
  • Time factors
  • United States
  • Viral load
  • Women

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Increase in single-tablet regimen use and associated improvements in adherence-related outcomes in HIV-Infected Women. / Hanna, David B.; Hessol, Nancy A.; Golub, Elizabeth; Cocohoba, Jennifer M.; Cohen, Mardge H.; Levine, Alexandra M.; Wilson, Tracey E.; Young, Mary; Anastos, Kathryn; Kaplan, Robert C.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 65, No. 5, 15.04.2014, p. 587-596.

Research output: Contribution to journalArticle

Hanna, DB, Hessol, NA, Golub, E, Cocohoba, JM, Cohen, MH, Levine, AM, Wilson, TE, Young, M, Anastos, K & Kaplan, RC 2014, 'Increase in single-tablet regimen use and associated improvements in adherence-related outcomes in HIV-Infected Women', Journal of Acquired Immune Deficiency Syndromes, vol. 65, no. 5, pp. 587-596. https://doi.org/10.1097/QAI.0000000000000082
Hanna, David B. ; Hessol, Nancy A. ; Golub, Elizabeth ; Cocohoba, Jennifer M. ; Cohen, Mardge H. ; Levine, Alexandra M. ; Wilson, Tracey E. ; Young, Mary ; Anastos, Kathryn ; Kaplan, Robert C. / Increase in single-tablet regimen use and associated improvements in adherence-related outcomes in HIV-Infected Women. In: Journal of Acquired Immune Deficiency Syndromes. 2014 ; Vol. 65, No. 5. pp. 587-596.
@article{700203385ce04ec1ae10ac7e3d47b824,
title = "Increase in single-tablet regimen use and associated improvements in adherence-related outcomes in HIV-Infected Women",
abstract = "Introduction: The use of single-tablet antiretroviral therapy (ART) regimens and its implications on adherence among HIV-infected women have not been well described. Methods: Participants were enrolled in the Women's Interagency HIV Study, a longitudinal study of HIV infection in US women. We examined semiannual trends in single-tablet regimen use and ART adherence, defined as self-reported 95{\%} adherence in the past 6 months, during 2006-2013. In a nested cohort study, we assessed the comparative effectiveness of a single-tablet versus a multiple-tablet regimen with respect to adherence, virologic suppression, quality of life, and AIDS-defining events, using propensity score matching to account for demographic, behavioral, and clinical confounders. We also examined these outcomes in a subset of women switching from a multiple- to single-tablet regimen using a case-crossover design. Results: We included 15,523 person-visits, representing 1727 women (53{\%} black, 29{\%} Hispanic, 25{\%} IDU, median age 47). Use of single-tablet regimens among ART users increased from 7{\%} in 2006{\%} to 27{\%} in 2013; adherence increased from 78{\%} to 85{\%} during the same period (both P , 0.001). Single-tablet regimen use was significantly associated with increased adherence (adjusted risk ratio: 1.05; 95{\%} confidence interval: 1.03 to 1.08) and virologic suppression (risk ratio: 1.06; 95{\%} confidence interval: 1.01 to 1.11), while associations with improved quality of life and fewer AIDS-defining events did not achieve statistical significance. Similar findings were observed among the subset of switchers. Conclusions: Single-tablet regimen use was associated with increased adherence and virologic suppression. Despite this, 15{\%} of women prescribed ART were still not optimally adherent; additional interventions are needed to maximize therapeutic benefits.",
keywords = "Adherence, Antiretroviral therapy, HIV, Time factors, United States, Viral load, Women",
author = "Hanna, {David B.} and Hessol, {Nancy A.} and Elizabeth Golub and Cocohoba, {Jennifer M.} and Cohen, {Mardge H.} and Levine, {Alexandra M.} and Wilson, {Tracey E.} and Mary Young and Kathryn Anastos and Kaplan, {Robert C.}",
year = "2014",
month = "4",
day = "15",
doi = "10.1097/QAI.0000000000000082",
language = "English (US)",
volume = "65",
pages = "587--596",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Increase in single-tablet regimen use and associated improvements in adherence-related outcomes in HIV-Infected Women

AU - Hanna, David B.

AU - Hessol, Nancy A.

AU - Golub, Elizabeth

AU - Cocohoba, Jennifer M.

AU - Cohen, Mardge H.

AU - Levine, Alexandra M.

AU - Wilson, Tracey E.

AU - Young, Mary

AU - Anastos, Kathryn

AU - Kaplan, Robert C.

PY - 2014/4/15

Y1 - 2014/4/15

N2 - Introduction: The use of single-tablet antiretroviral therapy (ART) regimens and its implications on adherence among HIV-infected women have not been well described. Methods: Participants were enrolled in the Women's Interagency HIV Study, a longitudinal study of HIV infection in US women. We examined semiannual trends in single-tablet regimen use and ART adherence, defined as self-reported 95% adherence in the past 6 months, during 2006-2013. In a nested cohort study, we assessed the comparative effectiveness of a single-tablet versus a multiple-tablet regimen with respect to adherence, virologic suppression, quality of life, and AIDS-defining events, using propensity score matching to account for demographic, behavioral, and clinical confounders. We also examined these outcomes in a subset of women switching from a multiple- to single-tablet regimen using a case-crossover design. Results: We included 15,523 person-visits, representing 1727 women (53% black, 29% Hispanic, 25% IDU, median age 47). Use of single-tablet regimens among ART users increased from 7% in 2006% to 27% in 2013; adherence increased from 78% to 85% during the same period (both P , 0.001). Single-tablet regimen use was significantly associated with increased adherence (adjusted risk ratio: 1.05; 95% confidence interval: 1.03 to 1.08) and virologic suppression (risk ratio: 1.06; 95% confidence interval: 1.01 to 1.11), while associations with improved quality of life and fewer AIDS-defining events did not achieve statistical significance. Similar findings were observed among the subset of switchers. Conclusions: Single-tablet regimen use was associated with increased adherence and virologic suppression. Despite this, 15% of women prescribed ART were still not optimally adherent; additional interventions are needed to maximize therapeutic benefits.

AB - Introduction: The use of single-tablet antiretroviral therapy (ART) regimens and its implications on adherence among HIV-infected women have not been well described. Methods: Participants were enrolled in the Women's Interagency HIV Study, a longitudinal study of HIV infection in US women. We examined semiannual trends in single-tablet regimen use and ART adherence, defined as self-reported 95% adherence in the past 6 months, during 2006-2013. In a nested cohort study, we assessed the comparative effectiveness of a single-tablet versus a multiple-tablet regimen with respect to adherence, virologic suppression, quality of life, and AIDS-defining events, using propensity score matching to account for demographic, behavioral, and clinical confounders. We also examined these outcomes in a subset of women switching from a multiple- to single-tablet regimen using a case-crossover design. Results: We included 15,523 person-visits, representing 1727 women (53% black, 29% Hispanic, 25% IDU, median age 47). Use of single-tablet regimens among ART users increased from 7% in 2006% to 27% in 2013; adherence increased from 78% to 85% during the same period (both P , 0.001). Single-tablet regimen use was significantly associated with increased adherence (adjusted risk ratio: 1.05; 95% confidence interval: 1.03 to 1.08) and virologic suppression (risk ratio: 1.06; 95% confidence interval: 1.01 to 1.11), while associations with improved quality of life and fewer AIDS-defining events did not achieve statistical significance. Similar findings were observed among the subset of switchers. Conclusions: Single-tablet regimen use was associated with increased adherence and virologic suppression. Despite this, 15% of women prescribed ART were still not optimally adherent; additional interventions are needed to maximize therapeutic benefits.

KW - Adherence

KW - Antiretroviral therapy

KW - HIV

KW - Time factors

KW - United States

KW - Viral load

KW - Women

UR - http://www.scopus.com/inward/record.url?scp=84898017184&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84898017184&partnerID=8YFLogxK

U2 - 10.1097/QAI.0000000000000082

DO - 10.1097/QAI.0000000000000082

M3 - Article

C2 - 24326606

AN - SCOPUS:84898017184

VL - 65

SP - 587

EP - 596

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - 5

ER -