{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T16:45:53Z","timestamp":1765557953336,"version":"3.48.0"},"reference-count":39,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Studies of nursing home (NH) residents show lower than expected antiretroviral therapy (ART) use, but it is unclear whether ART use changes across the transition from the community to long-term NH stay.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine changes in ART use across the transition from the community to long-term NH stay.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort study examined long stays in US NHs for people with HIV in a sample of 5% of Medicare claims from 2014 to 2019. Stays were at least 30 days long, had at least 3 months between multiple stays, and were for those continuously enrolled in Medicare for the stay and 6 months before. Analysis was completed in May 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Admission year demographics included age, race and ethnicity (non-Hispanic Black, non-Hispanic White, and other [American Indian or Alaska Native, Asian or Pacific Islander, other, and unknown]), binary sex, Medicaid eligibility, whether the stay was preceded by a skilled nursing stay, and whether disability was Medicare original eligibility. NH characteristics included for-profit status, census region, and facility quality rating.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Linear regression estimated changes in the proportion of days covered by 3-drug ART, and hierarchical multinomial logistic regression estimated the risk of never having, losing, or gaining ART vs always having it, across the transition from the community to long-term NH stay.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There were 713 long NH stays for 657 people with HIV (mean [SD] age, 61.0 [11.4] years) across 598 facilities; 271 stays (38%) were for people aged 65 years and older. Only 23 individuals lost ART (3%), 97 individuals (14%) gained ART, 185 individuals (26%) never had ART, and 408 individuals (57%) always had ART across the transition. Excluding those who lost ART, all other groups were mostly men (never, 132 men [71%]; always, 289 men [71%]; gained, 72 men [74%]) and Black (never, 85 individuals [46%]; always, 237 individuals [58%]; gained, 58 individuals [60%]). There was an increase in the proportion of days covered (mean intercept \u03b1\u2009=\u200913.92; 95% CI, 9.57-18.29). Compared with always having ART, Black race (relative risk [RR], 0.52; 95% CI, 0.35-0.77), polypharmacy (RR, 0.41; 95% CI, 0.23-0.74), and disability as original Medicare eligibility (RR, 0.47; 95% CI, 0.29-0.77) were associated with lower risk of never having ART. For-profit facilities were associated with higher risk (RR, 1.63; 95% CI, 1.03-2.59) of never having ART. Polypharmacy was associated with lower risk of gaining ART (RR, 0.15; 95% CI, 0.05-0.49).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n These findings suggest that long-term NH stays may be associated with improved ART use among people with HIV because most stays without ART never had ART before admission.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.48936","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T16:30:30Z","timestamp":1765557030000},"page":"e2548936","source":"Crossref","is-referenced-by-count":0,"title":["Antiretroviral Therapy Changes for Medicare Beneficiaries With HIV Transitioning to Long-Term Care"],"prefix":"10.1001","volume":"8","author":[{"given":"Brianne","family":"Olivieri-Mui","sequence":"first","affiliation":[{"name":"Department of Public Health and Health Sciences, Northeastern University, Boston, Massachusetts"},{"name":"The Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ira B.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy and Practice, Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen P.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"The Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laiji","family":"Yang","sequence":"additional","affiliation":[{"name":"The Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Brennan Ing","sequence":"additional","affiliation":[{"name":"Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Senier","sequence":"additional","affiliation":[{"name":"Department of Public Health and Health Sciences, Northeastern University, Boston, Massachusetts"},{"name":"Department of Sociology & Anthropology, Northeastern University, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"The Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"issue":"7","key":"zoi251314r1","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1111\/jgs.15949","article-title":"Nursing home residents by human immunodeficiency virus status: characteristics, dementia diagnoses and antipsychotic use.","volume":"67","author":"Miller","year":"2019","journal-title":"J Am Geriatr Soc"},{"key":"zoi251314r2","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25978","article-title":"\u201cWe can hardly even do it nowadays. 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Guidelines for the prevention and treatment of opportunistic infections and adults and adolescents with HIV. November 12, 2024. Accessed December 9, 2024. https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections\/whats-new"},{"key":"zoi251314r16","unstructured":"The Research Data Assistance Center. Find the CMS data file you need. Accessed October 14, 2025. https:\/\/resdac.org\/cms-data?tid_1%5B1%5D=1&tid%5B4931%5D=4931&tid%5B6066%5D=6066"},{"key":"zoi251314r17","unstructured":"Chronic Conditions Data Warehouse. Other chronic health, mental health, and potentially disabling conditions. Accessed December 16, 2024. https:\/\/www2.ccwdata.org\/web\/guest\/condition-categories?"},{"key":"zoi251314r18","unstructured":"Chronic Conditions Data Warehouse. 27 CCW chronic conditions algorithms: MBSF_CC_{YYYY} File. February 2023. 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