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Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders.
AIDS Care. 2009 Feb; 21(2):168-77.AC

Abstract

This paper examines factors associated with adherence to antiretroviral medications (ARVs) in an HIV-infected population at high risk for non-adherence: individuals living with psychiatric and substance abuse disorders. Data were examined from baseline interviews of a multisite cohort intervention study of 1138 HIV-infected adults with both a psychiatric and substance abuse disorder (based on a structured psychiatric research interview using DSM-IV criteria). The baseline interview documented mental illness and substance use in the past year, mental illness and substance abuse severity, demographics, service utilization in the past three months, general health and HIV-related conditions, self-reported spirituality and self-reported ARV medication use. Among the participants, 62% were prescribed ARVs at baseline (n = 542) and 45% of those on ARVs reported skipping medications in the past three days. Reports of non-adherence were significantly associated with having a detectable viral load (p<.01). The factors associated with non-adherence were current drug and alcohol abuse, increased psychological distress, less attendance at medical appointments, non-adherence to psychiatric medications and lower self-reported spirituality. Increased psychological distress was significantly associated with non-adherence, independent of substance abuse (p<.05). The data suggest that both mental illness and substance use must be addressed in HIV-infected adults living with these co-morbid illnesses to improve adherence to ARVs.

Authors+Show Affiliations

HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, USA. cam14@columbia.eduNo 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
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

19229685

Citation

Mellins, Claude Ann, et al. "Adherence to Antiretroviral Medications and Medical Care in HIV-infected Adults Diagnosed With Mental and Substance Abuse Disorders." AIDS Care, vol. 21, no. 2, 2009, pp. 168-77.
Mellins CA, Havens JF, McDonnell C, et al. Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders. AIDS Care. 2009;21(2):168-77.
Mellins, C. A., Havens, J. F., McDonnell, C., Lichtenstein, C., Uldall, K., Chesney, M., Santamaria, E. K., & Bell, J. (2009). Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders. AIDS Care, 21(2), 168-77. https://doi.org/10.1080/09540120802001705
Mellins CA, et al. Adherence to Antiretroviral Medications and Medical Care in HIV-infected Adults Diagnosed With Mental and Substance Abuse Disorders. AIDS Care. 2009;21(2):168-77. PubMed PMID: 19229685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders. AU - Mellins,Claude Ann, AU - Havens,Jennifer F, AU - McDonnell,Cheryl, AU - Lichtenstein,Carolyn, AU - Uldall,Karina, AU - Chesney,Margaret, AU - Santamaria,E Karina, AU - Bell,James, PY - 2009/2/21/entrez PY - 2009/2/21/pubmed PY - 2009/3/28/medline SP - 168 EP - 77 JF - AIDS care JO - AIDS Care VL - 21 IS - 2 N2 - This paper examines factors associated with adherence to antiretroviral medications (ARVs) in an HIV-infected population at high risk for non-adherence: individuals living with psychiatric and substance abuse disorders. Data were examined from baseline interviews of a multisite cohort intervention study of 1138 HIV-infected adults with both a psychiatric and substance abuse disorder (based on a structured psychiatric research interview using DSM-IV criteria). The baseline interview documented mental illness and substance use in the past year, mental illness and substance abuse severity, demographics, service utilization in the past three months, general health and HIV-related conditions, self-reported spirituality and self-reported ARV medication use. Among the participants, 62% were prescribed ARVs at baseline (n = 542) and 45% of those on ARVs reported skipping medications in the past three days. Reports of non-adherence were significantly associated with having a detectable viral load (p<.01). The factors associated with non-adherence were current drug and alcohol abuse, increased psychological distress, less attendance at medical appointments, non-adherence to psychiatric medications and lower self-reported spirituality. Increased psychological distress was significantly associated with non-adherence, independent of substance abuse (p<.05). The data suggest that both mental illness and substance use must be addressed in HIV-infected adults living with these co-morbid illnesses to improve adherence to ARVs. SN - 1360-0451 UR - https://www.unboundmedicine.com/medline/citation/19229685/Adherence_to_antiretroviral_medications_and_medical_care_in_HIV_infected_adults_diagnosed_with_mental_and_substance_abuse_disorders_ L2 - https://www.tandfonline.com/doi/full/10.1080/09540120802001705 DB - PRIME DP - Unbound Medicine ER -