Impact of mail order pharmacy use and travel time to pharmacy on viral suppression among people living with HIV.

ABSTRACT

This study aimed to evaluate the impact of mail order pharmacy services and travel time to pharmacy on HIV viral suppression rates among people living with HIV. For adult patients receiving HIV care from 2010 to 2015 at an urban HIV care clinic, we collected demographics, pharmacy type, viral load, and patient home and pharmacy address. We geocoded addresses and measured travel time to pharmacy by car and public transportation. No difference was observed in recent viral suppression rates based on pharmacy type (p = 0.41), distance to pharmacy (p = 0.16), or travel time to pharmacy by car (p = 0.20) or public transportation (p = 0.15). The only factors significantly associated with sustained viral suppression were number of doses per day of antiretroviral therapy, with patients prescribed twice daily regimens less likely to be virally suppressed than those prescribed once daily regimens (aOR 0.4, 95% CI, [0.1, 0.6]) and average household income in patients' zip code, with patients living in zip codes with average household income <$40,000 per year less likely to be virally suppressed than those living in zip codes with average income >$55,000 per year (aOR 0.2. 95% CI, [0.1, 0.7]).