DSM-5 substance use disorder symptom clusters and HIV antiretroviral therapy (ART) adherence

Margaret M. Paschen-Wolff, Aimee N.C. Campbell, Susan Tross, Tse Hwei Choo, Martina Pavlicova, Don Des Jarlais

Research output: Contribution to journalArticlepeer-review


This study examines self-reported 30-day antiretroviral therapy (ART) adherence among 101 people living with HIV and substance use disorders (SUD) in New York City in terms of Diagnostic and Statistical Manual–5th Edition (DSM-5) SUD symptom clusters: impaired control, social impairment, risky use and pharmacological criteria. Overall, 60.4% met DSM-5 criteria for stimulant, 55.5% for alcohol, 34.7% for cannabis and 25.7% for opioid SUD. Of the 76 participants with a current ART prescription, 75.3% reported at least 90% 30-day adherence. Participants with vs. without alcohol SUD were significantly less likely to report ART adherence (64.3% vs. 88.2%, p =.017). Endorsement of social impairment significantly differed among adherent vs. non-adherent participants with alcohol SUDs (74.1% vs. 100%, p =.038) and with opioid SUDs (94.1% vs. 50.0%, p =.040). Understanding specific SUD symptom clusters may assist providers and patients in developing strategies to improve ART adherence.

Original languageEnglish (US)
Pages (from-to)645-650
Number of pages6
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue number5
StatePublished - May 3 2020


  • Antiretroviral therapy
  • DSM-5
  • medication adherence
  • substance use disorders

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health


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