{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T05:58:40Z","timestamp":1773295120656,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T00:00:00Z","timestamp":1566518400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["1R01MH102202\u201001A1"],"award-info":[{"award-number":["1R01MH102202\u201001A1"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["1R01MH109394\u201001A1"],"award-info":[{"award-number":["1R01MH109394\u201001A1"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,8]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Adherence to antiretroviral therapy (ART<\/jats:styled-content>) is essential to reduce HIV<\/jats:styled-content>\u2010related morbidity and mortality as well as the risk of virological failure and HIV<\/jats:styled-content> transmission. We determined the trends in ART<\/jats:styled-content> adherence during the periods of therapeutic advances, wider use of ART<\/jats:styled-content> and greater attention to ART<\/jats:styled-content> adherence. To understand the general trends in medication adherence, we compared ART<\/jats:styled-content> adherence with medications for other common chronic conditions.<\/jats:p><\/jats:sec>Methods<\/jats:title>A retrospective cohort study using Medicaid claims between 2001 and 2012 from 14 US<\/jats:styled-content> states with the highest HIV<\/jats:styled-content> prevalence. Medicaid is the largest source of care for HIV<\/jats:styled-content> patients in the US<\/jats:styled-content>. We identified Medicaid beneficiaries with HIV<\/jats:styled-content> who initiated ART<\/jats:styled-content> between 2001 and 2010 (n=23,343). Comparison groups included (1) HIV<\/jats:styled-content>\u2010 persons who initiated a statin, angiotensin\u2010converting enzyme inhibitor or angiotensin receptor blocker (ACEI<\/jats:styled-content>\/ARB<\/jats:styled-content>), or metformin and (2) HIV<\/jats:styled-content>+ persons who initiated these control medications while on and not on ART<\/jats:styled-content>. We estimated adjusted odds of >90% medication implementation during the two years following initiation.<\/jats:p><\/jats:sec>Results<\/jats:title>The proportion of HIV<\/jats:styled-content>+ persons with >90% ART<\/jats:styled-content> implementation increased from 33.5% in those who initiated in 2001 to 46.4% in 2005 and 52.4% in 2010. ART<\/jats:styled-content> initiators in 2007 to 2010 had 53% increased odds of >90% implementation compared to those in 2001 to 2003 (adjusted OR<\/jats:styled-content> 1.53, 99% CI<\/jats:styled-content>: 1.34 to 1.75). Older age, male, White race, newer ART<\/jats:styled-content> regimens and absence of substance use indicators were also associated with increased odds of >90% ART<\/jats:styled-content> implementation. No or minimal improvements were found in the implementation of control medications in HIV<\/jats:styled-content>\u2010 persons. For HIV<\/jats:styled-content>\u2010 persons, the adjusted OR<\/jats:styled-content>s comparing 2007\u20132010 to 2001\u20132003 were 1.06, 1.01 and 1.19 for statins, ACEI<\/jats:styled-content>\/ARB<\/jats:styled-content>, metformin respectively. HIV<\/jats:styled-content>+ persons who were on ART<\/jats:styled-content> had, on average, 15.0 (SD<\/jats:styled-content>: 4.2) and 16.1 (SD<\/jats:styled-content>: 3.4) percentage points higher >90% implementation rates of concurrent statins, ACEI<\/jats:styled-content>\/ARB<\/jats:styled-content> or metformin compared to HIV<\/jats:styled-content>\u2010 persons and HIV<\/jats:styled-content>+ persons who were not on ART<\/jats:styled-content> respectively.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Adherence to ART<\/jats:styled-content> substantially improved between 2001 and 2012. Nevertheless, the absolute rates of >90% implementation were low for all groups examined. Substantial disparities by age, sex and race were present, drawing attention to the need to continue to enhance medication adherence. Further studies are required to examine whether these trends and disparities persist in the most recent period.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25382","type":"journal-article","created":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T07:26:04Z","timestamp":1566545164000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Trends in medication adherence in HIV<\/scp> patients in the US<\/scp>, 2001 to 2012: an observational cohort study"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2870-976X","authenticated-orcid":false,"given":"Bora","family":"Youn","sequence":"first","affiliation":[{"name":"Department of Health Services, Policy & Practice Brown University School of Public Health Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa I","family":"Shireman","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy & Practice Brown University School of Public Health Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoojin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy & Practice Brown University School of Public Health Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9985-9266","authenticated-orcid":false,"given":"Omar","family":"Gal\u00e1rraga","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy & Practice Brown University School of Public Health Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ira B","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy & Practice Brown University School of Public Health Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,23]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"US Department of Health and Human Services.Guidelines for the use of antiretroviral agents in HIV\u20101 infected adults and adolescents. 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