Polypharmacy Prevalence Trends in HIV-Positive Men in the United States

By infectiousdiseaseadvisor.com

While polypharmacy is expected to be prevalent in men who are HIV-positive, researchers have found that polypharmacy prevalence of non-HIV medications appears to increase over time in people living with HIV (PLWH), as well as their uninfected counterparts, according to study results published in PLoS ONE.
Researchers evaluated polypharmacy (defined as the concurrent use of 5 or more medications) prevalence of non-HIV medications over a 12-year period by gathering data on non-HIV medication use, HIV status, age, race/ethnicity, enrollment period, and medication insurance for 3160 HIV-positive and HIV-negative participants in the Multicenter AIDS Cohort Study (MACS) from 2004 to 2016.

They found that the prevalence of polypharmacy across all study visits was 18.6% and that it was higher in HIV-positive participants compared with HIV-negative participants (24.4% vs 11.6%, P <.0001).
In participants 50 and older, HIV-positive participants had an increase in polypharmacy from 38.4% to 46.8% and from 16.7% to 46.0% in HIV-negative participants, while rates in participants younger than 50 remained stable in HIV-positive participants but increased from 5.6% to 20.4% in HIV-negative participants.
After adjusting for age, race/ethnicity, and medication insurance, HIV-positive participants had a higher prevalence of polypharmacy than HIV-negative participants (25.3% vs 18.7%, P <.0001). However, a convergence of polypharmacy prevalence was observed between HIV-positive and -negative participants by the end of the observation.
Older age, white race, and having medication insurance coverage were associated with higher polypharmacy prevalence.

The investigators concluded that “Increased rates of comorbidities among the participants drove the main finding of increasing rates of polypharmacy over time.” They added, “We also observed a convergence of polypharmacy prevalence between HIV-positive and -negative participants by the end of the observation period, which could be explained by increasing healthcare visits by HIV-negative participants.”

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