The Impact of the AIDS Drug Assistance Program (ADAP) on Use of Highly Active Antiretroviral and Antihypertensive Therapy Among HIV-Infected Women

Yi, Thomas PharmD; Cocohoba, Jennifer PharmD; Cohen, Mardge MD; Anastos, Kathryn MD; DeHovitz, Jack A MD, MPH; Kono, Naoko MPH; Hanna, David B MS; Hessol, Nancy A MSPH

JAIDS Journal of Acquired Immune Deficiency Syndromes: 1 March 2011 - Volume 56 - Issue 3 - pp 253-262
doi: 10.1097/QAI.0b013e31820a9d04
Clinical Science

Objectives: To evaluate the association between enrollment into an AIDS Drug Assistance Program (ADAP) and use of highly active antiretroviral therapy (HAART) and antihypertensive therapy.

Methods: Cross-sectional analyses of data were performed on HAART-eligible women enrolled in the California (n = 439), Illinois (n = 168), and New York (n = 487) Women's Interagency HIV Study sites. A subset of HIV-infected women with hypertension (n = 395) was also analyzed. Unadjusted and adjusted backward stepwise elimination logistic regression measured the association between demographic, behavioral, and health service factors and nonuse of HAART or antihypertensive medication.

Results: In adjusted analysis of HAART nonuse, women without ADAP were significantly more likely not to use HAART (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.5-3.7) than women with ADAP. In adjusted analysis of antihypertensive medication nonuse, women without ADAP had an increased but not significant odds of antihypertensive medication nonuse (OR, 2.4; 95% CI, 0.93-6.0) than women with ADAP.

Conclusions: Government-funded programs for prescription drug coverage such as ADAP may play an important role in how HIV-positive women access and use essential medications for chronic diseases.

From the *School of Pharmacy, University of California, San Francisco, CA; †CORE Center, John H. Stroger Hospital of Cook County, Chicago, IL; ‡Department of Medicine, Montefiore Medical Center, Bronx, NY; §SUNY Downstate Medical Center, Brooklyn, NY; Center for Health Professions, University of Southern California, Los Angeles, CA; and ¶Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.

Received for publication September 3, 2010; accepted December 8, 2010.

The Women's Interagency HIV Study (WIHS) is funded by the National Institute of Allergy and Infectious Diseases and by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The study is cofunded by the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute on Deafness and Other Communication Disorders. Funding is also provided by the National Center for Research Resources.

A portion of these data was previously presented at the American College of Clinical Pharmacy (ACCP) 2010 Spring Practice and Research Forum, April 24, 2010, Charlotte, NC.

Thomas Yi and Nancy Hessol conceptualized and designed the study, performed the data analysis, and prepared the draft manuscript. Jennifer Cocohoba contributed to the conceptualization and provided clinical guidance. All authors contributed to data collection and reviewing as well as editing of the manuscript.

The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

Correspondence to: Nancy A. Hessol, MSPH, University of California San Francisco, 405 Irving Street, 2nd Floor, San Francisco, CA 94122 (e-mail: Nancy.Hessol@ucsf.edu).

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