title: Drug use and medication adherence among HIV-1 infected individuals.
abstract: This longitudinal study examined the impact of drug use and abuse on medication adherence among 150 HIV-infected individuals, 102 who tested urinalysis positive for recent illicit drug use. Medication adherence was tracked over a 6-month period using an electronic monitoring device (MEMS caps). Over the 6-month study drug-positive participants demonstrated significantly worse medication adherence than did drug-negative participants (63 vs. 79%, respectively). Logistic regression revealed that drug use was associated with over a fourfold greater risk of adherence failure. Stimulant users were at greatest risk for poor adherence. Based upon within-participants analyses comparing 3-day adherence rates when actively using versus not using drugs, this appears to be more a function of state rather than trait. These data suggest that it is the acute effects of intoxication, rather than stable features that may be characteristic of the drug-using populace, which leads to difficulties with medication adherence.
authors.affiliation: David Geffen School of Medicine, University of California at Los Angeles, 760 Westwood Plaza, Room C8-747, Los Angeles, CA 90024, USA. chinkin@ucla.edu
authors.forename: Charles H
authors.initials: CH
authors.lastname: Hinkin
authors.forename: Terry R
authors.initials: TR
authors.lastname: Barclay
authors.forename: Steven A
authors.initials: SA
authors.lastname: Castellon
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Levine
authors.forename: Ramani S
authors.initials: RS
authors.lastname: Durvasula
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Marion
authors.forename: Hector F
authors.initials: HF
authors.lastname: Myers
authors.forename: Douglas
authors.initials: D
authors.lastname: Longshore
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D003042:Cocaine; D016903:Drug Monitoring / Q000379:methods; D004581:Electronics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D016015:Logistic Models; D008297:Male; D008694:Methamphetamine; D008875:Middle Aged; D010349:Patient Compliance; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D008694:Methamphetamine; D003042:Cocaine