Yale University

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

TitleMedication persistence of HIV-infected drug users on directly administered antiretroviral therapy.
Publication TypeJournal Article
Year of Publication2013
AuthorsIng, Eileen C., Jason W. Bae, Duncan Smith-Rohrberg Maru, and Frederick L. Altice
JournalAIDS and behavior
Date Published2013 Jan
KeywordsAdult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Behavior, Addictive, CD4 Lymphocyte Count, Connecticut, Directly Observed Therapy, Drug Users, Female, HIV Infections, Humans, Interviews as Topic, Kaplan-Meier Estimate, Male, Medication Adherence, Proportional Hazards Models, Randomized Controlled Trials as Topic, RNA, Viral, Severity of Illness Index, Substance Abuse, Intravenous, Treatment Outcome, Viral Load
AbstractPatient 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.
Alternate JournalAIDS Behav

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