To quantify the use of long-acting injectable antiretroviral therapy (LA-ART) among Medicare beneficiaries with HIV and characterize differences in treatment patterns and outcomes between those receiving oral ART and LA-ART.
Key Findings:
Uptake of LA-ART was low, with only 3.0% of Medicare beneficiaries using it by 2023, highlighting a critical gap in treatment access.
Younger individuals (<55 years) were more likely to receive LA-ART compared to older individuals, indicating age-related disparities in treatment uptake.
American Indian or Alaska Native individuals were less likely to receive LA-ART than White individuals, reflecting racial disparities in access.
Beneficiaries with chronic conditions like Alzheimer disease and chronic kidney disease were less likely to receive LA-ART, suggesting treatment barriers for those with complex health needs.
Dual-eligible beneficiaries and those enrolled in Medicare Advantage were more likely to receive LA-ART, indicating the role of financial support in treatment access.
Interpretation:
The uptake of LA-ART among Medicare beneficiaries is uneven, with significant disparities based on age, race, and chronic conditions, reflecting broader issues in HIV care access that need to be addressed.
Limitations:
The study is descriptive and cannot establish causal relationships, limiting the understanding of treatment patterns.
Lack of clinical detail and inability to capture patient or physician-level factors affecting treatment choice may skew results.
Limited generalizability to individuals enrolled in Medicaid and commercial insurance may affect the applicability of findings.
Conclusion:
Early patterns suggest a need for targeted strategies to ensure equitable access to LA-ART, particularly for marginalized populations and older individuals with complex health needs, such as enhancing financial support and addressing systemic barriers.
