Drug Use and Medication Adherence among HIV-1 Infected Individuals

Abstract

This longitudinal study examined the impact of drug use and abuse on medication adherence among 150 HIV-infected individuals, 102 who tested urinalysis positive for recent illicit drug use. Medication adherence was tracked over a 6-month period using an electronic monitoring device (MEMS caps). Over the 6-month study drug-positive participants demonstrated significantly worse medication adherence than did drug-negative participants (63 vs. 79%, respectively). Logistic regression revealed that drug use was associated with over a fourfold greater risk of adherence failure. Stimulant users were at greatest risk for poor adherence. Based upon within-participants analyses comparing 3-day adherence rates when actively using versus not using drugs, this appears to be more a function of state rather than trait. These data suggest that it is the acute effects of intoxication, rather than stable features that may be characteristic of the drug-using populace, which leads to difficulties with medication adherence.

Assessing Problematic Substance Use in HIV Care: Which Questions Elicit Accurate Patient Disclosures?

“…[1][2][3][4][5][6][7][8][9][10][11] Alcohol, cocaine, and heroin use have all been shown to significantly increase ART non-adherence in patients living with HIV (PLWH). [12][13][14] A meta-analysis of the association between alcohol use and ART adherence found that alcohol use is associated with a 40-50 % decrease in ART adherence.…”

Self-efficacy, effort and control expectancy in the antirretroviral treatment adherence in methadone maintenance patients / Autoeficacia, esfuerzo y expectativas de control en la adhesión al tratamiento antirretroviral en pacientes VIH+ (...)

“…De entre las variables explicativas de la falta de adhesión a la TARGA en esta población el consumo de drogas es la que se erige como una de las barreras más claras para conseguir dicha adhesión (Battaglioli-DeNero, 2007;Hinkin et al, 2007). El tratamiento con sustitutivos opiáceos, como la metadona, ha contribuido a mejorar la supervivencia de la población adicta a drogas por vía parenteral, aunque su efecto protector más que por el efecto propiamente farmacológico esté basado en la posibilidad que brinda de reducir daños (Esteban, Gimeno, Barril, De la Cruz, 2004) además de contribuir junto a otros factores como son la organización y la estrategia del tratamiento a aumentar la retención de los pacientes (Camacho, Gimeno, Linares, Gimeno, 2003).…”

"People need to listen to us": Empowering people living with HIV/AIDS through positive prevention.

“…This is of particular concern given that morbidity can be worse, disease progression -16-more rapid, and treatment more difficult for HIV co-infected individuals (PHAC, 2007) Hogg et al (1998), Ory andMack (1998), andPalella et al (1998) found that the introduction of highly active antiretroviral therapy (HAART) has substantially reduced HIV/AIDS associated morbidity and mortality (as cited in Hinkin et al, 2007). Palepu et al (2006) reports methadone maintenance therapy (MMT) played a significant role in providing improved health outcomes for this susceptible population.…”

“…Reback, Larkins, and Shoptaw (2003) suggest that environmental instability induces stimulant abuse (as cited in Hinkin et al, 2007). Callaghan, Tavares, and Lawren (2007) report the high rates of reciprocal movement between on-and off-reserve locations are a critical public health concern.…”

“…Half of the individuals on combination therapies are likely to fail to take their medication due to poor self-management, such as missed dosage and time, and not following dietary instructions (Murphy et al, 2001;Nieuwkerk et al, 2001; as cited in Hinkin et al, 2007). The main problem is that " [u]nstable housing environments are associated with elevated risk of HIV-infection due to risk behaviours that take place in these environments" (Corneil, 2006, p. 80).…”