Illicit Drug Use: Can it Predict Adherence to Antiretroviral Therapy?

Martini, Michela; Recchia, Elena; Nasta, Paola; Castanotto, Daniela; Chiaffarino, Francesça; Parazzini, Fabio; Agnoletto, Vittorio

doi:10.1023/b:ejep.0000032353.03967.ef

Cited by 25 publications

(13 citation statements)

References 8 publications

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“…In contrast, Martini et al [38] found that heroin, cocaine, and alcohol users were not more likely to report nonadherence. In our data, alcohol use and crack use, but not recent injection drug use, were associated with nonadherence.…”

Section: Discussionmentioning

confidence: 88%

Patient and Regimen Characteristics Associated with Self-Reported Nonadherence to Antiretroviral Therapy

et al. 2007

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BackgroundNonadherence to antiretroviral therapy (ARVT) is an important behavioral determinant of the success of ARVT. Nonadherence may lead to virological failure, and increases the risk of development of drug resistance. Understanding the prevalence of nonadherence and associated factors is important to inform secondary HIV prevention efforts.Methodology/Principal FindingsWe used data from a cross-sectional interview study of persons with HIV conducted in 18 U.S. states from 2000–2004. We calculated the proportion of nonadherent respondents (took <95% of prescribed doses in the past 48 hours), and the proportion of doses missed. We used multivariate logistic regression to describe factors associated with nonadherence. Nine hundred and fifty-eight (16%) of 5,887 respondents reported nonadherence. Nonadherence was significantly (p<0.05) associated with black race and Hispanic ethnicity; age <40 years; alcohol or crack use in the prior 12 months; being prescribed ≥4 medications; living in a shelter or on the street; and feeling “blue” ≥14 of the past 30 days. We found weaker associations with having both male-male sex and injection drug use risks for HIV acquisition; being prescribed ARVT for ≥21 months; and being prescribed a protease inhibitor (PI)-based regimen not boosted with ritonavir. The median proportion of doses missed was 50%. The most common reasons for missing doses were forgetting and side effects.Conclusions/SignificanceSelf-reported recent nonadherence was high in our study. Our data support increased emphasis on adherence in clinical settings, and additional research on how providers and patients can overcome barriers to adherence.

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Section: Discussionmentioning

confidence: 88%

Patient and Regimen Characteristics Associated with Self-Reported Nonadherence to Antiretroviral Therapy

et al. 2007

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“…Esse mesmo autor encontrou associação significativa em dois outros artigos publicados em 2007. Em um desses artigos, escrito juntamente com Rosof e Mustanski, Parsons avaliou os subfatores do padrão de uso de álcool e demonstrou que entre os não aderentes é a quantidade de drinks consumidos pelo indivíduo que prediz se haverá ou não falhas na adesão [17][18][19][20][21] .…”

Section: Resultsunclassified

Associação entre uso de álcool em indivíduos com AIDS e adesão ao tratamento antirretroviral: uma revisão da literatura

Rego

2010

J. bras. psiquiatr.

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rESUMo objetivo: O objetivo deste trabalho foi fazer uma revisão sistemática da literatura, utilizando a base de dados MedLine, sobre o tema: uso/abuso/dependência de álcool como um fator de risco à redução da adesão, à redução na supressão da carga viral ou ao pior desfecho clínico em pacientes com AIDS em uso de highly active antiretroviral therapy (HAART). Método: Foi realizada uma pesquisa sistemática na base de dados MedLine utilizando como unitermos "HAART", "adherence" e "alcohol", na busca de artigos que versassem sobre a temática: avaliação ou associação de uso/abuso/dependência de álcool e adesão/supressão da carga viral/ desfecho clínico nos pacientes em uso de terapia antirretroviral. resultados: A busca resultou em 65 artigos. Contudo, apenas 21 deles contemplaram os critérios de inclusão e foram selecionados. Foi encontrada associação positiva entre uso/abuso/dependência de álcool e baixa adesão/baixa supressão da carga viral/pior desfecho clínico em 18 (85,7%) artigos. Conclusão: O uso/abuso/dependência de álcool é um fator de risco para baixa adesão/baixa supressão da carga viral/pior desfecho clínico nos indivíduos em uso de HAART. aBStraCt Objective: The purpose of this work was to make a systematic review of the literature, using the MedLine data basis, about the alcohol usage/abuse/dependence as a risk factor to the adherence reduction, the viral load reduction or even a worse clinical outcome in HIV patients in the usage of highly active antiretroviral therapy (HAART). Method: It was made a systematic research in theMedLine data basis using the words: " HAART", "adherence" and "alcohol"

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“…Six studies used a combination of adherence measurements, e.g., self-report and MEMS (Crystal et al 2001;Kerr et al 2005;Lucas et al 2001;Martini et al 2004;McNabb et al 2001;Roca et al 1999). …”

Section: Study Characteristicsmentioning

confidence: 99%

Adherence to Antiretroviral Therapy Among HIV-Infected Drug Users: A Meta-Analysis

et al. 2008

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We conducted a meta-analysis of studies assessing adherence to highly active antiretroviral therapy (HAART) and a qualitative systematic review of factors associated with better HAART outcomes among HIV+ drug users (DU). Thirty-eight studies were considered, which analyzed 14,960 patients (11,394 HIV+ DU, 76.2%). Overall adherence (pooled percent of DU classified as adherent in each study) was 0.60 (95% CI: 0.52-0.68), similar to levels identified by studies conducted with HIV+ patients who are not drug users. Time frame used to measure adherence was an independent predictor of inter-study heterogeneity. The systematic review identified better HAART outcomes among former DU, those with less severe psychiatric conditions, those receiving opioid substitution therapy and/or psychosocial support. Patients initiating HAART with lower viral load and higher CD4 counts, and those without co-infections also had better treatment outcomes. Our findings suggest that HIV+ DU tend to be inappropriately assumed to be less adherent and unlikely to achieve desirable treatment outcomes, when compared to their non-DU cohort.

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Illicit Drug Use: Can it Predict Adherence to Antiretroviral Therapy?

Cited by 25 publications

References 8 publications

Patient and Regimen Characteristics Associated with Self-Reported Nonadherence to Antiretroviral Therapy

Patient and Regimen Characteristics Associated with Self-Reported Nonadherence to Antiretroviral Therapy

Associação entre uso de álcool em indivíduos com AIDS e adesão ao tratamento antirretroviral: uma revisão da literatura

Adherence to Antiretroviral Therapy Among HIV-Infected Drug Users: A Meta-Analysis

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