The impact of illicit drug use and substance abuse treatment on adherence to HAART

Abstract

High levels of adherence to highly active antiretroviral therapy (HAART) are essential for virologic suppression and longer survival in patients with HIV. We examined the effects of substance abuse treatment, current versus former substance use, and hazardous/binge drinking on adherence to HAART. During 2003, 659 HIV patients on HAART in primary care were interviewed. Adherence was defined as ≥95% adherence to all antiretroviral medications. Current substance users used illicit drugs and/or hazardous/binge drinking within the past six months, while former users had not used substances for at least six months. Logistic regression analyses of adherence to HAART included demographic, clinical and substance abuse variables. Sixty-seven percent of the sample reported 95% adherence or greater. However, current users (60%) were significantly less likely to be adherent than former (68%) or never users (77%). In multivariate analysis, former users in substance abuse treatment were as adherent to HAART as never users (Adjusted Odds Ratio (AOR) 0.82; p>0.5). In contrast, former users who had not received recent substance abuse treatment were significantly less adherent than never users (AOR=0.61; p=0.05). Current substance users were significantly less adherent than never users, regardless of substance abuse treatment (p<0.01). Substance abuse treatment interacts with current versus former drug use

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

“…Entre esses obstáculos, o uso de álcool, que é um comportamento modificável, temse mostrado como um forte preditor de falhas na adesão e piora no desfecho clínico [25][26][27][28][29][30][31][32][33][34][35] .…”

HIV Women's Health: A Study of Gynecological Healthcare Service Utilization in a U.S. Urban Clinic Population

“…20 Although there is scant literature on the association of substance abuse with primary care or gynecological appointment adherence, several studies examining the HIV-infected population in general have linked such factors as substance abuse to HIV medication nonadherence. [28][29][30][31] One study of 150 HIV-infected people found that drug use was associated with a 4-fold greater risk of medication adherence failure. 32 Unfortunately substance use and abuse in women is closely linked to HIV: the CDC reported that 1 in 5 new HIV diagnoses in women were related to injection drug use in 2005.…”

Monitoring Drug Use Among HIV/AIDS Patients in Brazil: Should we Combine Self-Report and Urinalysis?

“…Illicit drug use in HIV-infected patients can be linked to impairment of physical and mental health, low access to care, low health-related quality of life, suboptimal adherence to HIV treatment and poorer health outcomes than other HIV risk groups [5][6][7][8].…”