TY - JOUR
T1 - Impact of active drug use on antiretroviral therapy adherence and viral suppression in HIV-infected drug users
AU - Arnsten, Julia H.
AU - Demas, Penelope A.
AU - Grant, Richard W.
AU - Gourevitch, Marc N.
AU - Farzadegan, Homayoon
AU - Howard, Andrea A.
AU - Schoenbaum, Ellie E.
N1 - Funding Information:
This study was funded by the National Institute on Drug Abuse (R01-DA11869, R01-DA104347), and by a Robert Wood Johnson Generalist Physician Faculty Scholar Award to Dr. Arnsten.
PY - 2002
Y1 - 2002
N2 - Despite a burgeoning literature on adherence to HIV therapies, few studies have examined the impact of ongoing drug use on adherence and viral suppression, and none of these have utilized electronic monitors to quantify adherence among drug users. We used 262 electronic monitors to measure adherence with all antiretrovirals in 85 HIV-infected current and former drug users, and found that active cocaine use, female gender, not receiving Social Security benefits, not being married, screening positive for depression, and the tendency to use alcohol or drugs to cope with stress were all significantly associated with poor adherence. The strongest predictor of poor adherence and, in turn, failure to maintain viral suppression, was active cocaine use. Overall adherence among active cocaine users was 27%, compared to 68% among subjects who reported no cocaine use during the 6-month study period. Consequently, 13% of active cocaine users maintained viral suppression, compared to 46% of nonusers. Interventions to improve adherence should focus on reducing cocaine use, developing adaptive coping skills, and identifying and treating depression.
AB - Despite a burgeoning literature on adherence to HIV therapies, few studies have examined the impact of ongoing drug use on adherence and viral suppression, and none of these have utilized electronic monitors to quantify adherence among drug users. We used 262 electronic monitors to measure adherence with all antiretrovirals in 85 HIV-infected current and former drug users, and found that active cocaine use, female gender, not receiving Social Security benefits, not being married, screening positive for depression, and the tendency to use alcohol or drugs to cope with stress were all significantly associated with poor adherence. The strongest predictor of poor adherence and, in turn, failure to maintain viral suppression, was active cocaine use. Overall adherence among active cocaine users was 27%, compared to 68% among subjects who reported no cocaine use during the 6-month study period. Consequently, 13% of active cocaine users maintained viral suppression, compared to 46% of nonusers. Interventions to improve adherence should focus on reducing cocaine use, developing adaptive coping skills, and identifying and treating depression.
KW - Adherence
KW - Antiretroviral therapy
KW - Drug users
KW - Electronic monitors
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U2 - 10.1046/j.1525-1497.2002.10644.x
DO - 10.1046/j.1525-1497.2002.10644.x
M3 - Article
C2 - 12047736
AN - SCOPUS:0036282710
SN - 0884-8734
VL - 17
SP - 377
EP - 381
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 5
ER -