Single- and multi-tablet HIV regimens go head-to-head

"Many of us [clinicians] default to using single-tablet regimens."

By
Alun Evans
August 26, 2026
5 min

MDSpire News

Objective:

To compare the effectiveness of contemporary once-daily single-tablet regimens (STRs) and multi-tablet regimens (MTRs) in achieving viral suppression among people with HIV enrolled in Washington state Medicaid.

Approach:

Study Design: The study linked 2023 Washington state Medicaid administrative data with statewide HIV RNA surveillance data for 2,874 adults with HIV.
Viral Suppression Definition: Viral suppression was defined as an HIV RNA level below 200 copies/mL, with adjustments for various demographic and social factors.

Key Findings:

90.4% of Medicaid enrollees were virally suppressed.
Viral suppression rates were 91.6% for the single-tablet regimen and 88.9% for first-line MTRs, with no statistically significant difference after adjustment.
Among those experiencing unstable housing, suppression rates were nearly identical at 78.8% for the single-tablet regimen and 78.2% for first-line MTRs.
Housing status was a significant factor; lower suppression rates were observed among those experiencing unstable housing.

Interpretation:

The study suggests that the difference in efficacy between single-tablet and multi-tablet regimens is minimal, and housing stability plays a crucial role in treatment adherence and viral suppression.

Limitations:

The observational analysis could not account for factors influencing regimen selection, such as antiretroviral resistance and comorbidities.
Findings may not be generalizable beyond Washington state due to unique Medicaid policies and support services.

Conclusion:

The small virologic advantage of single-tablet therapy does not justify its higher cost, indicating a need for a more holistic approach to HIV treatment that considers effectiveness, cost, and patient needs.