Ridgway Jessica P, Friedman Eleanor E, Choe Justine, Nguyen Cynthia T, Schuble Todd, Pettit Natasha N
Department of Medicine, University of Chicago, Chicago, IL, USA.
The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.
AIDS Care. 2020 Nov;32(11):1372-1378. doi: 10.1080/09540121.2020.1757019. Epub 2020 May 4.
This study aimed to evaluate the impact of mail order pharmacy services and travel time to pharmacy on HIV viral suppression rates among people living with HIV. For adult patients receiving HIV care from 2010 to 2015 at an urban HIV care clinic, we collected demographics, pharmacy type, viral load, and patient home and pharmacy address. We geocoded addresses and measured travel time to pharmacy by car and public transportation. No difference was observed in recent viral suppression rates based on pharmacy type ( = 0.41), distance to pharmacy ( = 0.16), or travel time to pharmacy by car ( = 0.20) or public transportation ( = 0.15). The only factors significantly associated with sustained viral suppression were number of doses per day of antiretroviral therapy, with patients prescribed twice daily regimens less likely to be virally suppressed than those prescribed once daily regimens (aOR 0.4, 95% CI, [0.1, 0.6]) and average household income in patients' zip code, with patients living in zip codes with average household income <$40,000 per year less likely to be virally suppressed than those living in zip codes with average income >$55,000 per year (aOR 0.2. 95% CI, [0.1, 0.7]).
本研究旨在评估邮购药房服务以及前往药房的时间对艾滋病毒感染者的艾滋病毒病毒抑制率的影响。对于2010年至2015年期间在一家城市艾滋病毒护理诊所接受艾滋病毒护理的成年患者，我们收集了人口统计学信息、药房类型、病毒载量以及患者的家庭住址和药房地址。我们对地址进行了地理编码，并测量了开车和乘坐公共交通工具前往药房的时间。基于药房类型（P = 0.41）、到药房的距离（P = 0.16）、开车前往药房的时间（P = 0.20）或乘坐公共交通工具前往药房的时间（P = 0.15），未观察到近期病毒抑制率存在差异。与持续病毒抑制显著相关的唯一因素是抗逆转录病毒疗法的每日剂量数，每日服用两次方案的患者病毒抑制的可能性低于每日服用一次方案的患者（调整后比值比0.4，95%置信区间，[0.1, 0.6]），以及患者邮政编码区域的平均家庭收入，居住在平均家庭收入低于每年40,000美元邮政编码区域的患者病毒抑制的可能性低于居住在平均收入高于每年55,000美元邮政编码区域的患者（调整后比值比0.2，95%置信区间，[0.1, 0.7]）。
