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Uptake and adherence to highly active antiretroviral therapy among HIV-infected people with alcohol and other substance use problems: the impact of substance abuse treatment.
Addiction 2004; 99(3):361-8A

Abstract

AIM

We examined the association of substance abuse treatment with uptake, adherence and virological response to highly active antiretroviral therapy (HAART) among HIV-infected people with a history of alcohol problems.

DESIGN

Prospective cohort study.

METHODS

A standardized questionnaire was administered to 349 HIV-infected participants with a history of alcohol problems regarding demographics, substance use, use of substance abuse treatment and uptake of and adherence to HAART. These subjects were followed every 6 months for up to seven occasions. We defined substance abuse treatment services as any of the following in the past 6 months: 12 weeks in a half-way house or residential facility; 12 visits to a substance abuse counselor or mental health professional; or participation in any methadone maintenance program. Our outcome variables were uptake of antiretroviral therapy, 30-day self-reported adherence and HIV viral load suppression.

FINDINGS

At baseline, 59% (205/349) of subjects were receiving HAART. Engagement in substance abuse treatment was independently associated with receiving antiretroviral therapy (adjusted OR; 95% CI: 1.70; 1.03-2.83). Substance abuse treatment was not associated with 30-day adherence or HIV viral load suppression. More depressive symptoms (0.48; 0.32-0.78) and use of drugs or alcohol in the previous 30 days (0.17; 0.11-0.28) were associated with worse 30-day adherence. HIV viral load suppression was positively associated with higher doses of antiretroviral medication (1.29; 1.15-1.45) and older age (1.04; 1.00-1.07) and negatively associated with use of drugs or alcohol in the previous 30 days (0.51; 0.33-0.78).

CONCLUSION

Substance abuse treatment was associated with receipt of HAART; however, it was not associated with adherence or HIV viral load suppression. Substance abuse treatment programs may provide an opportunity for HIV-infected people with alcohol or drug problems to openly address issues of HIV care including enhancing adherence to HAART.

Authors+Show Affiliations

Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. anita@hivnet.ubc.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14982549

Citation

Palepu, Anita, et al. "Uptake and Adherence to Highly Active Antiretroviral Therapy Among HIV-infected People With Alcohol and Other Substance Use Problems: the Impact of Substance Abuse Treatment." Addiction (Abingdon, England), vol. 99, no. 3, 2004, pp. 361-8.
Palepu A, Horton NJ, Tibbetts N, et al. Uptake and adherence to highly active antiretroviral therapy among HIV-infected people with alcohol and other substance use problems: the impact of substance abuse treatment. Addiction. 2004;99(3):361-8.
Palepu, A., Horton, N. J., Tibbetts, N., Meli, S., & Samet, J. H. (2004). Uptake and adherence to highly active antiretroviral therapy among HIV-infected people with alcohol and other substance use problems: the impact of substance abuse treatment. Addiction (Abingdon, England), 99(3), pp. 361-8.
Palepu A, et al. Uptake and Adherence to Highly Active Antiretroviral Therapy Among HIV-infected People With Alcohol and Other Substance Use Problems: the Impact of Substance Abuse Treatment. Addiction. 2004;99(3):361-8. PubMed PMID: 14982549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Uptake and adherence to highly active antiretroviral therapy among HIV-infected people with alcohol and other substance use problems: the impact of substance abuse treatment. AU - Palepu,Anita, AU - Horton,Nicholas J, AU - Tibbetts,Nicole, AU - Meli,Seville, AU - Samet,Jeffrey H, PY - 2004/2/26/pubmed PY - 2004/4/20/medline PY - 2004/2/26/entrez SP - 361 EP - 8 JF - Addiction (Abingdon, England) JO - Addiction VL - 99 IS - 3 N2 - AIM: We examined the association of substance abuse treatment with uptake, adherence and virological response to highly active antiretroviral therapy (HAART) among HIV-infected people with a history of alcohol problems. DESIGN: Prospective cohort study. METHODS: A standardized questionnaire was administered to 349 HIV-infected participants with a history of alcohol problems regarding demographics, substance use, use of substance abuse treatment and uptake of and adherence to HAART. These subjects were followed every 6 months for up to seven occasions. We defined substance abuse treatment services as any of the following in the past 6 months: 12 weeks in a half-way house or residential facility; 12 visits to a substance abuse counselor or mental health professional; or participation in any methadone maintenance program. Our outcome variables were uptake of antiretroviral therapy, 30-day self-reported adherence and HIV viral load suppression. FINDINGS: At baseline, 59% (205/349) of subjects were receiving HAART. Engagement in substance abuse treatment was independently associated with receiving antiretroviral therapy (adjusted OR; 95% CI: 1.70; 1.03-2.83). Substance abuse treatment was not associated with 30-day adherence or HIV viral load suppression. More depressive symptoms (0.48; 0.32-0.78) and use of drugs or alcohol in the previous 30 days (0.17; 0.11-0.28) were associated with worse 30-day adherence. HIV viral load suppression was positively associated with higher doses of antiretroviral medication (1.29; 1.15-1.45) and older age (1.04; 1.00-1.07) and negatively associated with use of drugs or alcohol in the previous 30 days (0.51; 0.33-0.78). CONCLUSION: Substance abuse treatment was associated with receipt of HAART; however, it was not associated with adherence or HIV viral load suppression. Substance abuse treatment programs may provide an opportunity for HIV-infected people with alcohol or drug problems to openly address issues of HIV care including enhancing adherence to HAART. SN - 0965-2140 UR - https://www.unboundmedicine.com/medline/citation/14982549/Uptake_and_adherence_to_highly_active_antiretroviral_therapy_among_HIV_infected_people_with_alcohol_and_other_substance_use_problems:_the_impact_of_substance_abuse_treatment_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0965-2140&date=2004&volume=99&issue=3&spage=361 DB - PRIME DP - Unbound Medicine ER -