Differences between different antiretroviral therapy regimens switching patterns among people living with HIV

Advances in antiretroviral therapy (ART) have extended the life expectancy of people living with HIV (PLHIV). The long-term goals of ART for PLHIV were better medication convenience and fewer side effects. The development of the Internet and increased education allow PLHIV to understand evolving and optimized regimens and participated in decision-making. Understanding ART switching patterns can help identify key populations for medical institutions or social organizations' publicity and education.

This cross-sectional study recruited PLHIV (≥ 18 years) receiving ART at the Hospital's outpatient clinic between February 13 and October 26, 2023. Social characteristics, ART switching patterns, and health education-related information were collected. The patient-driven switching pattern was defined as PLHIV volunteering to switch treatment regimens, while the physician-driven pattern was described as doctors suggesting regimen switches based on routine test results. Multinomial regression was used to explore factors associated with ART switching patterns.

Out of 1877 PLHIV analyzed, 93.98% were male with a median age of 39 (33, 48) years. 34.04% (639/1877) had switched ART regimens, and 11.88% made the switch themselves. Economic status, age, and attending education lectures were associated with ART switching patterns. Participants with an average income of less than 5000 yuan tended to switch regimens driven by physicians, while those with steady jobs and under 30 years old were more likely to switch on their own. Those who never attended education lectures or had an average income of less than 10,000 yuan tended not to change ART regimens at all.

Promoting active switching and optimizing ART may be achieved through health education in medical institutions for ART decision-making in the future.