Adherence to Current Recommendations for Antiretroviral Therapy in Health Region 11 of the Province of Buenos Aires

Abstract

Introduction: Antiretroviral therapy (ART) has evolved toward more effective and simplified regimens, with a preference for integrase inhibitor–based combinations. However, few studies in Argentina have evaluated the actual appropriateness of treatments used in relation to national guidelines. The aim of this study was to assess the adequacy of antiretroviral regimens according to current local recommendations in the public healthcare subsector of Health Region 11 (RS11), Province of Buenos Aires, during 2025.

Methods: An analytical, observational, cross-sectional study was conducted. People living with HIV older than one month and receiving follow-up care in the public healthcare subsector of RS11 were included. Treatment regimens were classified as preferred or alternative according to the 2023 Argentine Consensus on Antiretroviral Therapy.

Results: A total of 1,869 individuals were identified in follow-up care: 1,849 aged over 15 years and 20 under 15 years. Among adults, 76.6% were receiving preferred regimens. Alternative regimens were concentrated in a limited number of healthcare facilities and were more common among individuals with a longer time since HIV diagnosis. Viral suppression was higher among those receiving preferred regimens (82.8% vs. 75.3%), with alternative regimens being associated with a 55% lower likelihood of achieving an undetectable viral load. Among individuals under 15 years of age, regimen adequacy was 55%, and viral suppression showed a similar trend, although statistical power was insufficient to demonstrate significant differences.

Conclusion: Health Region 11 demonstrates a high level of adherence to national ART guidelines, particularly among adults, with preferred regimens associated with better virological outcomes. Challenges remain in certain healthcare facilities and within the pediatric population, where adherence to recommendations is lower and clinical complexity is greater. This study provides national evidence on the real-world implementation of ART guidelines and their programmatic implications.