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Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users.
J Acquir Immune Defic Syndr. 2007 Nov 01; 46 Suppl 2:S64-71.JA

Abstract

BACKGROUND

Active drug use is often associated with poor adherence, but few studies have determined psychosocial correlates of adherence in injection drug users (IDUs).

METHODS

Of 1161 Intervention for Seropositive Injectors-Research and Evaluation study enrollees, 636 were taking antiretrovirals. We assessed self-reported adherence to self-reported antiretroviral regimens and medication errors, which we defined as daily doses that were inconsistent with standard or alternative antiretroviral prescriptions.

RESULTS

Most subjects (75%, n=477) self-reported good (>or=90%) adherence, which was strongly associated with an undetectable viral load. Good adherence was independently associated with being a high school graduate, not sharing injection equipment, fewer depressive symptoms, positive attitudes toward antiretrovirals, higher self-efficacy for taking antiretrovirals as prescribed, and greater sense of responsibility to protect others from HIV. Medication errors were made by 54% (n=346) and were strongly associated with a detectable viral load and fewer CD4 cells. Errors were independently associated with nonwhite race and with depressive symptoms, poorer self-efficacy for safer drug use, and worse attitudes toward HIV medications.

CONCLUSIONS

Modifiable factors associated with poor adherence, including depressive symptoms and poor self-efficacy, should be targeted for intervention. Because medication errors are prevalent and associated with a detectable viral load and fewer CD4 cells, interventions should include particular efforts to identify medication taking inconsistent with antiretroviral prescriptions.

Authors+Show Affiliations

Division of General Internal Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467, USA. jarnsten@montefiore.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

18089986

Citation

Arnsten, Julia H., et al. "Factors Associated With Antiretroviral Therapy Adherence and Medication Errors Among HIV-infected Injection Drug Users." Journal of Acquired Immune Deficiency Syndromes (1999), vol. 46 Suppl 2, 2007, pp. S64-71.
Arnsten JH, Li X, Mizuno Y, et al. Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users. J Acquir Immune Defic Syndr. 2007;46 Suppl 2:S64-71.
Arnsten, J. H., Li, X., Mizuno, Y., Knowlton, A. R., Gourevitch, M. N., Handley, K., Knight, K. R., & Metsch, L. R. (2007). Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users. Journal of Acquired Immune Deficiency Syndromes (1999), 46 Suppl 2, S64-71. https://doi.org/10.1097/QAI.0b013e31815767d6
Arnsten JH, et al. Factors Associated With Antiretroviral Therapy Adherence and Medication Errors Among HIV-infected Injection Drug Users. J Acquir Immune Defic Syndr. 2007 Nov 1;46 Suppl 2:S64-71. PubMed PMID: 18089986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users. AU - Arnsten,Julia H, AU - Li,Xuan, AU - Mizuno,Yuko, AU - Knowlton,Amy R, AU - Gourevitch,Marc N, AU - Handley,Kathleen, AU - Knight,Kelly R, AU - Metsch,Lisa R, AU - ,, PY - 2008/1/3/pubmed PY - 2008/1/18/medline PY - 2008/1/3/entrez SP - S64 EP - 71 JF - Journal of acquired immune deficiency syndromes (1999) JO - J. Acquir. Immune Defic. Syndr. VL - 46 Suppl 2 N2 - BACKGROUND: Active drug use is often associated with poor adherence, but few studies have determined psychosocial correlates of adherence in injection drug users (IDUs). METHODS: Of 1161 Intervention for Seropositive Injectors-Research and Evaluation study enrollees, 636 were taking antiretrovirals. We assessed self-reported adherence to self-reported antiretroviral regimens and medication errors, which we defined as daily doses that were inconsistent with standard or alternative antiretroviral prescriptions. RESULTS: Most subjects (75%, n=477) self-reported good (>or=90%) adherence, which was strongly associated with an undetectable viral load. Good adherence was independently associated with being a high school graduate, not sharing injection equipment, fewer depressive symptoms, positive attitudes toward antiretrovirals, higher self-efficacy for taking antiretrovirals as prescribed, and greater sense of responsibility to protect others from HIV. Medication errors were made by 54% (n=346) and were strongly associated with a detectable viral load and fewer CD4 cells. Errors were independently associated with nonwhite race and with depressive symptoms, poorer self-efficacy for safer drug use, and worse attitudes toward HIV medications. CONCLUSIONS: Modifiable factors associated with poor adherence, including depressive symptoms and poor self-efficacy, should be targeted for intervention. Because medication errors are prevalent and associated with a detectable viral load and fewer CD4 cells, interventions should include particular efforts to identify medication taking inconsistent with antiretroviral prescriptions. SN - 1525-4135 UR - https://www.unboundmedicine.com/medline/citation/18089986/Factors_associated_with_antiretroviral_therapy_adherence_and_medication_errors_among_HIV_infected_injection_drug_users_ L2 - http://dx.doi.org/10.1097/QAI.0b013e31815767d6 DB - PRIME DP - Unbound Medicine ER -