People living with HIV who use Medicare were younger than their HIV-negative counterparts and, despite having lower rates of diabetes, cardiovascular disease and other diseases, were more likely to be prescribed medications for those conditions and more likely to have multiple chronic conditions, according to a study presented at IDWeek 2021.
In 2018, a total of 86,856 people with HIV who had taken at least one antiretroviral medication were on Medicare, the federal public health insurance program that covers people over 65 and those with certain disabilities. Researcher Pengxiang Li, PhD, of the University of Pennsylvania, and colleagues compared the number of chronic conditions and medication prescriptions among people living with HIV with the number of chronic conditions and prescriptions among a random sample of 552,645 HIV-negative people on Medicare the same year.
The researchers found that the population of HIV-positive people on Medicare strongly reflect who is being diagnosed with HIV today: younger people, Black people, men, low-income people and people receiving Medicare because of a disability. And while people living with HIV were younger, they were just as likely to have three or more chronic conditions (70%) as their older peers without HIV (72%).
But those conditions varied by HIV status. HIV-negative people were more likely than HIV-positive people to have autoimmune disorders (44% versus 27%), hypertension (67% versus 55%), heart disease (32% versus 24%), high cholesterol (59% versus 50%), osteoporosis (8% versus 4%) and diabetes (29% versus 24%). But people with HIV outpaced their HIV-negative peers in diagnoses of mental health conditions (39% versus 25%), substance use (31% versus 11%), lung disease (22% versus 18%), kidney disease (29% versus 23%) and liver disease (16% versus 5%). Rates of gastrointestinal disorders were roughly similar.
While some of the most common health conditions requiring medication were more common among HIV-negative people, those living with HIV had more medication prescriptions filled in 2018, at 13, compared with nine among people without HIV. And although HIV-negative people had much higher rates of cardiovascular disease and diabetes, people with HIV took more cardiovascular and metabolic agents than their HIV negative peers. What’s more, people with HIV still took one more medication than people without the virus even when antiretroviral drugs were taken out of the equation.
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