SEATTLE — Among uninsured and underinsured HIV patients, recipients of Ryan White HIV/AID Program assistance have a greater likelihood of ART prescription and viral suppression vs. patients with other types of insurance, according to findings presented at CROI 2015.
“The Ryan White HIV/AIDS Program is the payer of last resort for HIV medical care, medications, and supportive services for uninsured and underinsured persons living with HIV in the United States,” the researchers wrote. “We assessed the association between Ryan White HIV/AIDS Program assistance, alone or in combination with other sources of health care coverage, and antiretroviral treatment prescription and viral suppression.”
The researchers used data from 2009-2010 on 8,691 HIV patients from the Medical Monitoring Project, a surveillance program with national data about HIV-infected adults undergoing medical treatment. They found that among HIV-infected adults, 40.2% received some level of Ryan White HIV/AIDS Program (RWHAP) assistance, while 14.7% depended exclusively on RWHAP assistance for HIV care. Almost 57% of patients had other health care coverage without RWHAP assistance, including private insurance (17%), Medicaid (16.6%), Medicare (3.3%) or both (9.6%). About 3% of patients had neither insurance nor RWHAP assistance.
ART was prescribed to 89.6% of patients, and 72.9% achieved viral suppression (≤ 200 copies/mL). Compared with uninsured patients without RWHAP assistance, uninsured patients with RWHAP assistance had a greater likelihood of being prescribed ART (43.6% vs. 93.7%; P < .01) and were more likely to achieve viral suppression (36.1% vs. 76.9%; P < .01).
Further analysis indicated that patients with RWHAP assistance were more likely to be prescribed ART than those with private insurance, Medicaid and Medicare (P ≤ .05). Patients with private insurance were 7% less likely to be virally suppressed than those with RWHAP only, while Medicaid patients were 15% less likely, and Medicare patients 10% less likely, to achieve viral suppression than those with RWHAP assistance only (P ≤ .05). Patients with RWHAP assistance in addition to private insurance or Medicaid coverage were more likely to be prescribed ART than those without RWHAP assistance (P ≤ .05). Likewise, those with supplementary RWHAP assistance in addition to Medicaid or Medicare coverage were more likely to achieve viral suppression than those without supplementary RWHAP assistance (P ≤ .05).
Bradley H, et al. Abstract 1064. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 23-26, 2015; Seattle.
Disclosure: The researchers report no relevant financial disclosures.