title: Substance abuse, adherence with antiretroviral therapy, and clinical outcomes among HIV-infected individuals.
abstract: Substance abuse and addiction are highly prevalent in HIV-infected individuals. Substance abuse is an important comorbidity that affects the delivery and outcomes of HIV medical management. In this paper I will review data examining the associations between substance abuse and HIV treatment and potential strategies to improve outcomes in this population that warrant further investigation. Current - but not past - substance abuse adversely affects engagement in care, acceptance of antiretroviral therapy, adherence with therapy, and long-term persistence in care. Substance abuse treatment appears to facilitate engagement in HIV care, and access to evidence-based treatment for substance abuse is central to addressing the HIV epidemic. Strategies that show promise for HIV-infected substance abusers include integrated treatment models, directly observed therapy, and incentive-based interventions.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States. glucas@jhmi.edu
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Lucas
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023801:Directly Observed Therapy; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D006297:Health Services Accessibility; D006801:Humans; D055118:Medication Adherence; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents