Evidence Hub

Real-World Persistence in Adults with HIV and Mental Health or Substance Use Disorders After Restarting Antiretroviral Therapy in the United States

Written by Aetion | Nov 26, 2025

People with HIV need consistent antiretroviral therapy to maintain viral suppression and avoid disease progression, yet treatment interruptions are common, especially among those with mental health or substance use disorders. This study used real-world data to compare the effectiveness of different antiretroviral therapy (ART) regimens in maintaining adherence after being restarted following a prolonged interruption.

Study Overview

Researchers analyzed US claims data from 2015 to 2024 to evaluate adults with HIV who had stopped an ART regimen for more than 90 days and later resumed the same therapy. Among individuals with a mental health or substance use disorder, the study compared persistence—defined as discontinuing or switching the restarted regimen—across several commonly recommended therapies. Patients restarting B/F/TAF were less likely to become nonpersistent than those receiving DTG/ABC/3TC or DTG-based multitablet regimens, and they had the lowest risk of switching compared with all DTG-based options. Patterns were broadly consistent in the wider population of all restarters, where many discontinued or switched therapy during follow-up.

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