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Impact of Active Drug Use on Antiretroviral Therapy Adherence and Viral Suppression in HIV‐infected Drug Users

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... Full description

Journal Title: Journal of general internal medicine : JGIM 2002-05, Vol.17 (5), p.377-381
Main Author: Arnsten, Julia H.
Other Authors: Demas, Penelope A. , Grant, Richard W. , Gourevitch, Marc N. , Farzadegan, Homayoon , Howard, Andrea A. , Schoenbaum, Ellie E.
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Boston, MA, USA: Blackwell Science Inc
ID: ISSN: 0884-8734
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title: Impact of Active Drug Use on Antiretroviral Therapy Adherence and Viral Suppression in HIV‐infected Drug Users
format: Article
creator:
  • Arnsten, Julia H.
  • Demas, Penelope A.
  • Grant, Richard W.
  • Gourevitch, Marc N.
  • Farzadegan, Homayoon
  • Howard, Andrea A.
  • Schoenbaum, Ellie E.
subjects:
  • adherence
  • antiretroviral therapy
  • Brief Reports
  • drug users
  • electronic monitors
ispartof: Journal of general internal medicine : JGIM, 2002-05, Vol.17 (5), p.377-381
description: 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.
language: eng
source:
identifier: ISSN: 0884-8734
fulltext: no_fulltext
issn:
  • 0884-8734
  • 1525-1497
url: Link


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titleImpact of Active Drug Use on Antiretroviral Therapy Adherence and Viral Suppression in HIV‐infected Drug Users
creatorArnsten, Julia H. ; Demas, Penelope A. ; Grant, Richard W. ; Gourevitch, Marc N. ; Farzadegan, Homayoon ; Howard, Andrea A. ; Schoenbaum, Ellie E.
creatorcontribArnsten, Julia H. ; Demas, Penelope A. ; Grant, Richard W. ; Gourevitch, Marc N. ; Farzadegan, Homayoon ; Howard, Andrea A. ; Schoenbaum, Ellie E.
descriptionDespite 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.
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subjectadherence ; antiretroviral therapy ; Brief Reports ; drug users ; electronic monitors
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titleImpact of Active Drug Use on Antiretroviral Therapy Adherence and Viral Suppression in HIV‐infected Drug Users
authorArnsten, Julia H. ; Demas, Penelope A. ; Grant, Richard W. ; Gourevitch, Marc N. ; Farzadegan, Homayoon ; Howard, Andrea A. ; Schoenbaum, Ellie E.
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0Arnsten, Julia H.
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0annual meeting of the Society of General Internal Medicine, San Francisco, Calif, May, 2000.
1Presented in part at the Seventh Conference on Retroviruses and Opportunistic Infections, San Francisco, Calif, January, 2000, and the 22
2nd
3Presented in part at the Seventh Conference on Retroviruses and Opportunistic Infections, San Francisco, Calif, January, 2000, and the 22nd annual meeting of the Society of General Internal Medicine, San Francisco, Calif, May, 2000.
abstractDespite 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.
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