Among HIV-positive individuals covered by Medicaid, a considerable proportion of those who stop their antiretroviral (ARV) treatment don’t restart therapy in a timely manner.

Tingting Zhang, MD, PhD, an assistant professor at the Brown University School of Public Health, and colleagues analyzed data on more than 100,000 HIV-positive Medicaid enrollees spanning 2001 to 2012.

Over 45,000 of these individuals discontinued ARV treatment at some point. Forty-four percent of them did not go back on treatment for the virus within 18 months.

The study authors found that being younger, being a woman, having two or more non-HIV-related health conditions and having a mental health diagnosis were each associated with not restarting ARV treatment within 18 months.

Attending three or more clinic visits as well as being hospitalized during the follow-up period were both linked to a higher likelihood of restarting treatment.

“These people could experience adverse health outcomes,” Zhang says of individuals who go off ARVs. “Outpatient visits improve drug reinitiation.”