Alarming data presented at the Ninth International AIDS Society Conference in Paris this week shows that HIV-positive people on Medicaid are more likely to not adhere to their medications, which of course is critical for them to keep the virus at bay to undetectable levels.
Results found that two-thirds of poz people insured by Medicaid had poor or suboptimal adherence to treatment — 51 percent poor, 19 percent suboptimal. And it doesn’t stop there: Researchers also found that Medicaid-insured poz people had longer hospital stays, more long-term care admissions, and significantly higher medical costs.
Other factors showing higher risk of non-adherence was younger age (in 2015, people between the ages 13 and 24 accounted for 22 percent of all new HIV diagnoses, according to the Centers for Disease Control and Prevention), those with dual Medicaid/Medicare insurance coverage, those new to antiretroviral therapy, and those absent of typical HIV symptoms.
Dr. Keith Dunn, the study investigator, and his team found this information by compiling claims from Medicaid databases in six states between 2012 and 2015, comparing HIV-positive people on Medicaid and associating costs between those who were suboptimal versus those who with optimal adherence.
As the report said, “While further research is needed to directly associate nonadherence to incremental costs associated with virologic failure and resistance,” health professionals need to be aware of the risk factors that might lead to someone not taking their meds.
Doctors should not take this lightly. In fact, given the fact that the world is edging closer to the UNAIDS’s 90-90-90 goal—calling for 90 percent of poz people to know their status, 90 percent of poz people to be on meds, and 90 percent of poz people to reach undetectable—the time for doctor/patient accountability is crucial.