Association of Chronic Conditions and Medication Burden with Patient Preferences for Long-Acting Antiretroviral Therapy in HIV Treatment
Author(s)
Zilin Cheng, MS1, Douglas Barthold, PhD1, Enrique M. Saldarriaga, PhD1, Brett Hauber, PhD2, Jacinda Tran, MBA, PharmD, PhD3, Vincent C. Marconi, MD4, Susan M. Graham, MD, MPH, PhD5;
1University of Washington CHOICE Institute, Seattle, WA, USA, 2Pfizer, Inc, New York, NY, USA, 3Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, WA, USA, 4Emory University School of Medicine, Atlanta, GA, USA, 5University of Washington Department of Global Health, Seattle, WA, USA
1University of Washington CHOICE Institute, Seattle, WA, USA, 2Pfizer, Inc, New York, NY, USA, 3Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, WA, USA, 4Emory University School of Medicine, Atlanta, GA, USA, 5University of Washington Department of Global Health, Seattle, WA, USA
Presentation Documents
OBJECTIVES: Long-acting antiretroviral therapies (LA-ART) offer alternatives to daily oral HIV treatment and may enhance adherence and quality of life. This study assessed associations between chronic conditions, medication burden, and patient preferences for HIV treatment modalities among people with HIV (PWH) in the United States.
METHODS: A discrete choice experiment was conducted among 699 PWH from Seattle (350) and Atlanta (349) between March 2021 and June 2022. Using latent-class analysis, participants were categorized into three preference-based classes: LA-Implant (29%), LA-Oral-or-Injection (35%), and Daily-or-LA-Oral (36%). Chronic conditions were identified using ICD-10 codes from chart reviews, and medication burden was assessed by the number of medications from prescription files. Among 647 PWH who consented to link their medical records (329 Seattle, 318 Atlanta), we used adjusted multinomial logistic regressions to evaluate associations between chronic comorbidities, medication burden, and preference class membership.
RESULTS: Participants who were female (relative risk ratio [RRR]=1.29, p=0.002), younger than 30 (RRR=4.86, p<0.001), or diabetic (RRR=2.38, p<0.001) favored LA-Implants over Daily-or-LA-Oral treatment, while those with hyperlipidemia were less likely to favor LA-Implants (RRR=0.84, p=0.008). Higher medication burden was associated with a 6.2% increase in preference for LA-Implant per additional drug (RRR=1.06, p=0.042). Participants with mental health disorders (RRR=1.30, p<0.001) favored LA-Oral-or-Injections over Daily-or-LA-Oral treatment, while those with hyperlipidemia were less likely to favor LA-Oral-or-Injections (RRR=0.72, p=0.008). Participants with four or more chronic conditions were 21% less likely to prefer LA-Oral-or-Injection over Daily-or-LA-Oral treatment (RRR=0.79, p<0.001).
CONCLUSIONS: Female, younger age, diabetes and higher medication burden were associated with a stronger preference for LA-Implants over Daily-or-LA-Oral treatment, while mental health conditions were associated with a stronger preference for LA-Oral-or-Injections. Those with hyperlipidemia and multimorbidity were less likely to prefer LA-Implant or Injection-based therapies. These findings highlight the role of chronic conditions and medication burden in shaping preferences for HIV treatment strategies.
METHODS: A discrete choice experiment was conducted among 699 PWH from Seattle (350) and Atlanta (349) between March 2021 and June 2022. Using latent-class analysis, participants were categorized into three preference-based classes: LA-Implant (29%), LA-Oral-or-Injection (35%), and Daily-or-LA-Oral (36%). Chronic conditions were identified using ICD-10 codes from chart reviews, and medication burden was assessed by the number of medications from prescription files. Among 647 PWH who consented to link their medical records (329 Seattle, 318 Atlanta), we used adjusted multinomial logistic regressions to evaluate associations between chronic comorbidities, medication burden, and preference class membership.
RESULTS: Participants who were female (relative risk ratio [RRR]=1.29, p=0.002), younger than 30 (RRR=4.86, p<0.001), or diabetic (RRR=2.38, p<0.001) favored LA-Implants over Daily-or-LA-Oral treatment, while those with hyperlipidemia were less likely to favor LA-Implants (RRR=0.84, p=0.008). Higher medication burden was associated with a 6.2% increase in preference for LA-Implant per additional drug (RRR=1.06, p=0.042). Participants with mental health disorders (RRR=1.30, p<0.001) favored LA-Oral-or-Injections over Daily-or-LA-Oral treatment, while those with hyperlipidemia were less likely to favor LA-Oral-or-Injections (RRR=0.72, p=0.008). Participants with four or more chronic conditions were 21% less likely to prefer LA-Oral-or-Injection over Daily-or-LA-Oral treatment (RRR=0.79, p<0.001).
CONCLUSIONS: Female, younger age, diabetes and higher medication burden were associated with a stronger preference for LA-Implants over Daily-or-LA-Oral treatment, while mental health conditions were associated with a stronger preference for LA-Oral-or-Injections. Those with hyperlipidemia and multimorbidity were less likely to prefer LA-Implant or Injection-based therapies. These findings highlight the role of chronic conditions and medication burden in shaping preferences for HIV treatment strategies.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PCR101
Topic
Patient-Centered Research
Disease
SDC: Infectious Disease (non-vaccine)