title: Increase in single-tablet regimen use and associated improvements in adherence-related outcomes in HIV-infected women.
abstract: BACKGROUND
  The use of single-tablet antiretroviral therapy (ART) regimens and its implications on adherence among HIV-infected women have not been well described.
  
  
  METHODS
  Participants were enrolled in the Women's Interagency HIV Study, a longitudinal study of HIV infection in US women. We examined semiannual trends in single-tablet regimen use and ART adherence, defined as self-reported 95% adherence in the past 6 months, during 2006-2013. In a nested cohort study, we assessed the comparative effectiveness of a single-tablet versus a multiple-tablet regimen with respect to adherence, virologic suppression, quality of life, and AIDS-defining events, using propensity score matching to account for demographic, behavioral, and clinical confounders. We also examined these outcomes in a subset of women switching from a multiple- to single-tablet regimen using a case-crossover design.
  
  
  RESULTS
  We included 15,523 person-visits, representing 1727 women (53% black, 29% Hispanic, 25% IDU, median age 47). Use of single-tablet regimens among ART users increased from 7% in 2006% to 27% in 2013; adherence increased from 78% to 85% during the same period (both P < 0.001). Single-tablet regimen use was significantly associated with increased adherence (adjusted risk ratio: 1.05; 95% confidence interval: 1.03 to 1.08) and virologic suppression (risk ratio: 1.06; 95% confidence interval: 1.01 to 1.11), while associations with improved quality of life and fewer AIDS-defining events did not achieve statistical significance. Similar findings were observed among the subset of switchers.
  
  
  CONCLUSIONS
  Single-tablet regimen use was associated with increased adherence and virologic suppression. Despite this, 15% of women prescribed ART were still not optimally adherent; additional interventions are needed to maximize therapeutic benefits.
authors: *Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; †Department of Clinical Pharmacy, University of California-San Francisco, San Francisco, CA; ‡Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; §Department of Medicine, Cook County Health and Hospitals System and Rush University, Chicago, IL; ‖City of Hope National Medical Center, Duarte, CA; ¶Department of Community Health Sciences, SUNY Downstate Medical Center, Brooklyn, NY; #Department of Medicine, Georgetown University Medical Center, Washington, DC; and **Department of Medicine, Montefiore Medical Center, Bronx, NY.
authors: David B
authors: DB
authors: Hanna
authors: Nancy A
authors: NA
authors: Hessol
authors: Elizabeth T
authors: ET
authors: Golub
authors: Jennifer M
authors: JM
authors: Cocohoba
authors: Mardge H
authors: MH
authors: Cohen
authors: Alexandra M
authors: AM
authors: Levine
authors: Tracey E
authors: TE
authors: Wilson
authors: Mary
authors: M
authors: Young
authors: Kathryn
authors: K
authors: Anastos
authors: Robert C
authors: RC
authors: Kaplan
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011788:Quality of Life; D013607:Tablets / Q000008:administration & dosage*; D016896:Treatment Outcome; D014481:United States; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents; D013607:Tablets