Behavioral practices regarding combination therapies for hiv/aids

We assessed knowledge and utilization of, and adherence to, combination antiretroviral therapies including protease inhibitors among 210 low-income persons living with HIV/AIDS (aged 18 to 52 years, M = 32.5 years; 43% Latino, 34% African American). Most (65%) had received protease inhibitors at some point, although only 54% had received them in the previous 3 months. Parents with AIDS were more likely to have taken protease inhibitors than young adults (72% vs. 33%). About half of those taking combination antiretroviral therapies reported consistent adherence (55%), even among the 64% who experienced side effects. However, the reliability of these reports appears moderate. More than half of those taking combination therapies reported improvements in their health (62%). Almost all participants reported having their viral loads tested (87%), on average 3.7 times (SD = 3.6 times). More than one third (38%) reported undetectable viral loads. Participants were moderately informed about protease inhibitors (64% of answers correct in a knowledge questionnaire). Using multivariate logistic regression, we found that those who abstained from substance use were more likely to be adherent (odds ratio = 4.75; 95% CI = 1.63 - 13.85). Adherence was not related to sexual behavior. These reports suggest that persons with AIDS are at risk for developing treatment-resistant strains of HIV because half or fewer have adequate levels of adherence, and further, a substantial minority are not on approved combination therapies. Interventions to help persons living with AIDS adhere to complex medication regimens are needed, particularly for those who use substances, as well as to assist young adults with overcoming barriers to receiving combination therapies.