2001-2015 年,医疗补助计划(Medicaid)受益人中的艾滋病毒感染者继续接受护理和坚持抗逆转录病毒疗法的情况。

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv Pub Date : 2024-11-01 Epub Date: 2024-07-30 DOI:10.1080/09540121.2024.2383901
Jacqueline E Rudolph, Keri L Calkins, Xueer Zhang, Yiyi Zhou, Xiaoqiang Xu, Eryka L Wentz, Corinne E Joshu, Bryan Lau
{"title":"2001-2015 年,医疗补助计划(Medicaid)受益人中的艾滋病毒感染者继续接受护理和坚持抗逆转录病毒疗法的情况。","authors":"Jacqueline E Rudolph, Keri L Calkins, Xueer Zhang, Yiyi Zhou, Xiaoqiang Xu, Eryka L Wentz, Corinne E Joshu, Bryan Lau","doi":"10.1080/09540121.2024.2383901","DOIUrl":null,"url":null,"abstract":"<p><p>Disparities in HIV care by socioeconomic status, place of residence, and race/ethnicity prevent progress toward epidemic control. No study has comprehensively characterized the HIV care cascade among people with HIV enrolled in Medicaid - an insurance source for low-income individuals in the US. We analyzed data from 246,127 people with HIV enrolled in Medicaid 2001-2015, aged 18-64, living in 14 US states. We estimated the monthly prevalence of four steps of the care cascade: retained in care/adherent to ART; retained/not adherent; not retained/adherent; not retained/not adherent. Beneficiaries were retained in care if they had an outpatient care encounter every six months. Adherence was based on medication possession ratio. We estimated prevalence using a non-parametric multi-state approach, accounting for death as a competing event and for Medicaid disenrollment using inverse probability of censoring weights. Across 2001-2015, the proportion of beneficiaries with HIV who were retained/ART adherent increased, overall and in all subgroups. By 2015, approximately half of beneficiaries were retained in care, and 42% of beneficiaries were ART adherent. We saw meaningful differences by race/ethnicity and region. Our work highlights an important disparity in the HIV care cascade by insurance status during this time period.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1668-1680"},"PeriodicalIF":1.2000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511646/pdf/","citationCount":"0","resultStr":"{\"title\":\"Retention in care and antiretroviral therapy adherence among Medicaid beneficiaries with HIV, 2001-2015.\",\"authors\":\"Jacqueline E Rudolph, Keri L Calkins, Xueer Zhang, Yiyi Zhou, Xiaoqiang Xu, Eryka L Wentz, Corinne E Joshu, Bryan Lau\",\"doi\":\"10.1080/09540121.2024.2383901\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Disparities in HIV care by socioeconomic status, place of residence, and race/ethnicity prevent progress toward epidemic control. No study has comprehensively characterized the HIV care cascade among people with HIV enrolled in Medicaid - an insurance source for low-income individuals in the US. We analyzed data from 246,127 people with HIV enrolled in Medicaid 2001-2015, aged 18-64, living in 14 US states. We estimated the monthly prevalence of four steps of the care cascade: retained in care/adherent to ART; retained/not adherent; not retained/adherent; not retained/not adherent. Beneficiaries were retained in care if they had an outpatient care encounter every six months. Adherence was based on medication possession ratio. We estimated prevalence using a non-parametric multi-state approach, accounting for death as a competing event and for Medicaid disenrollment using inverse probability of censoring weights. Across 2001-2015, the proportion of beneficiaries with HIV who were retained/ART adherent increased, overall and in all subgroups. By 2015, approximately half of beneficiaries were retained in care, and 42% of beneficiaries were ART adherent. We saw meaningful differences by race/ethnicity and region. Our work highlights an important disparity in the HIV care cascade by insurance status during this time period.</p>\",\"PeriodicalId\":48370,\"journal\":{\"name\":\"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv\",\"volume\":\" \",\"pages\":\"1668-1680\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511646/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/09540121.2024.2383901\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/09540121.2024.2383901","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/30 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 0

摘要

社会经济地位、居住地和种族/民族在 HIV 护理方面的差异阻碍了疫情控制的进展。在美国,医疗补助计划是低收入人群的保险来源,目前还没有任何研究全面描述了加入该计划的艾滋病病毒感染者的艾滋病护理流程。我们分析了美国 14 个州 2001-2015 年加入医疗补助计划的 246127 名 18-64 岁艾滋病病毒感染者的数据。我们估算了护理级联四个步骤的月流行率:保留护理/坚持抗逆转录病毒疗法;保留/不坚持;不保留/不坚持;不保留/不坚持。如果受益人每 6 个月接受一次门诊治疗,则视为继续接受治疗。依从性基于药物持有率。我们使用非参数多州方法估算了患病率,将死亡作为竞争事件,并使用反删减概率加权法估算了医疗补助的退出情况。在 2001-2015 年期间,无论是总体还是在所有分组中,感染艾滋病毒的受益人中坚持接受抗逆转录病毒治疗的比例都有所上升。到 2015 年,约有一半的受益人继续接受护理,42% 的受益人坚持抗逆转录病毒疗法。我们发现,不同种族/族裔和地区之间存在显著差异。我们的工作凸显了在此期间,不同保险状况的艾滋病护理级联中存在的重要差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Retention in care and antiretroviral therapy adherence among Medicaid beneficiaries with HIV, 2001-2015.

Disparities in HIV care by socioeconomic status, place of residence, and race/ethnicity prevent progress toward epidemic control. No study has comprehensively characterized the HIV care cascade among people with HIV enrolled in Medicaid - an insurance source for low-income individuals in the US. We analyzed data from 246,127 people with HIV enrolled in Medicaid 2001-2015, aged 18-64, living in 14 US states. We estimated the monthly prevalence of four steps of the care cascade: retained in care/adherent to ART; retained/not adherent; not retained/adherent; not retained/not adherent. Beneficiaries were retained in care if they had an outpatient care encounter every six months. Adherence was based on medication possession ratio. We estimated prevalence using a non-parametric multi-state approach, accounting for death as a competing event and for Medicaid disenrollment using inverse probability of censoring weights. Across 2001-2015, the proportion of beneficiaries with HIV who were retained/ART adherent increased, overall and in all subgroups. By 2015, approximately half of beneficiaries were retained in care, and 42% of beneficiaries were ART adherent. We saw meaningful differences by race/ethnicity and region. Our work highlights an important disparity in the HIV care cascade by insurance status during this time period.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.50
自引率
0.00%
发文量
172
期刊最新文献
Self-efficacy and consistent condom use by people living with HIV and seroconcordant and serodiscordant sexual partners in the Ceará, Brazil. Use of machine learning approaches to predict transition of retention in care among people living with HIV in South Carolina: a real-world data study. Utility of the Alcohol Use Disorder Inventory Test in determining caseness for alcohol use disorder among persons receiving antiretroviral therapy. Race/ethnicity-based discrimination, depressive symptoms, and smoking-related variables among people with HIV participating in a randomized clinical trial for cigarette smoking cessation. HIV and hepatitis C virus-related misinformation may contribute to rising rates of infection and suboptimal clinical outcomes among persons with substance use.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1