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Psychiatric and social barriers to HIV medication adherence in a triply diagnosed methadone population.
AIDS Patient Care STDS. 2003 Dec; 17(12):635-44.AP

Abstract

Although antiretrovirals can prolong life, medication adherence also poses a constant challenge for HIV-infected individuals because the success of antiretroviral regimens demands nearly perfect adherence to medications. This paper describes the psychiatric and social barriers to adherence in a convenience sample of HIV-positive clients in methadone treatment in the Bronx, New York. The study sample was part of a national study of HIV treatment adherence and health care utilization among triply diagnosed populations, the HIV/AIDS Treatment Adherence Health Outcomes and Cost Study. The triply diagnosed study sample is defined here as HIV-infected individuals who screened into the study with at least one psychiatric diagnosis in addition to opioid dependence on agonist therapy (methadone treatment) and at least one substance use diagnosis. Interviewers utilized modified versions of the Structured Clinical Interview for DSM-IV Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), and the Addiction Severity Index (ASI-Lite), among a battery of Cost Study instruments. Results showed that within this sample, borderline personality disorder was significantly associated with nonadherence to HIV medications. A related finding showed a significant relationship between serious social/family problems and nonadherence. These findings build on previous research on the impact of psychiatric illness on HIV medication adherence and suggest that psychiatric assessment and treatment options be linked to adherence interventions.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 98101-1313, USA. npalmer@jba-cht.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14746657

Citation

Palmer, Nancy B., et al. "Psychiatric and Social Barriers to HIV Medication Adherence in a Triply Diagnosed Methadone Population." AIDS Patient Care and STDs, vol. 17, no. 12, 2003, pp. 635-44.
Palmer NB, Salcedo J, Miller AL, et al. Psychiatric and social barriers to HIV medication adherence in a triply diagnosed methadone population. AIDS Patient Care STDS. 2003;17(12):635-44.
Palmer, N. B., Salcedo, J., Miller, A. L., Winiarski, M., & Arno, P. (2003). Psychiatric and social barriers to HIV medication adherence in a triply diagnosed methadone population. AIDS Patient Care and STDs, 17(12), 635-44.
Palmer NB, et al. Psychiatric and Social Barriers to HIV Medication Adherence in a Triply Diagnosed Methadone Population. AIDS Patient Care STDS. 2003;17(12):635-44. PubMed PMID: 14746657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychiatric and social barriers to HIV medication adherence in a triply diagnosed methadone population. AU - Palmer,Nancy B, AU - Salcedo,Jesus, AU - Miller,Alec L, AU - Winiarski,Mark, AU - Arno,Peter, PY - 2004/1/30/pubmed PY - 2004/2/27/medline PY - 2004/1/30/entrez SP - 635 EP - 44 JF - AIDS patient care and STDs JO - AIDS Patient Care STDS VL - 17 IS - 12 N2 - Although antiretrovirals can prolong life, medication adherence also poses a constant challenge for HIV-infected individuals because the success of antiretroviral regimens demands nearly perfect adherence to medications. This paper describes the psychiatric and social barriers to adherence in a convenience sample of HIV-positive clients in methadone treatment in the Bronx, New York. The study sample was part of a national study of HIV treatment adherence and health care utilization among triply diagnosed populations, the HIV/AIDS Treatment Adherence Health Outcomes and Cost Study. The triply diagnosed study sample is defined here as HIV-infected individuals who screened into the study with at least one psychiatric diagnosis in addition to opioid dependence on agonist therapy (methadone treatment) and at least one substance use diagnosis. Interviewers utilized modified versions of the Structured Clinical Interview for DSM-IV Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), and the Addiction Severity Index (ASI-Lite), among a battery of Cost Study instruments. Results showed that within this sample, borderline personality disorder was significantly associated with nonadherence to HIV medications. A related finding showed a significant relationship between serious social/family problems and nonadherence. These findings build on previous research on the impact of psychiatric illness on HIV medication adherence and suggest that psychiatric assessment and treatment options be linked to adherence interventions. SN - 1087-2914 UR - https://www.unboundmedicine.com/medline/citation/14746657/Psychiatric_and_social_barriers_to_HIV_medication_adherence_in_a_triply_diagnosed_methadone_population_ L2 - https://www.liebertpub.com/doi/10.1089/108729103771928690?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -