Medication persistence of HIV-infected drug users on directly administered antiretroviral therapy

AIDS Behav. 2013 Jan;17(1):113-21. doi: 10.1007/s10461-011-0082-0.

Abstract

Patient and regimen persistence in HIV-infected drug users are largely unknown. We evaluated patterns of medication non-persistence among HIV-infected drug users enrolled in a prospective, 6-month randomized controlled trial of directly administered antiretroviral therapy (DAART). Medication-taking behavior was assessed via direct observation and MEMS data. Of 74 participants who initiated DAART, 59 (80%) subjects were non-persistent with medication for 3 or more consecutive days. Thirty-one participants (42%) had 2 or more episodes of non-persistence. Higher depressive symptoms were strongly associated with non-persistence episodes of ≥ 3 days (AOR: 17.4, P = 0.02) and ≥ 7 days AOR: 5.4, P = 0.04). High addiction severity (AOR 3.2, P = 0.03) was correlated with non-persistence ≥ 7 days, and injection drug use (AOR: 15.2, P = 0.02) with recurrence of non-persistence ≥ 3 days. Time to regimen change was shorter for NNRTI-based regimens compared to PI-based ones (HR: 3.0, P = 0.03). There was no significant association between patterns of patient non-persistence and virological outcomes.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Behavior, Addictive
  • CD4 Lymphocyte Count
  • Connecticut
  • Directly Observed Therapy*
  • Drug Users / psychology*
  • Drug Users / statistics & numerical data
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • Humans
  • Interviews as Topic
  • Kaplan-Meier Estimate
  • Male
  • Medication Adherence*
  • Proportional Hazards Models
  • RNA, Viral / blood
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Substance Abuse, Intravenous / complications*
  • Substance Abuse, Intravenous / drug therapy
  • Treatment Outcome
  • Viral Load

Substances

  • Anti-HIV Agents
  • RNA, Viral