title: HIV-infected individuals with co-occurring bipolar disorder evidence poor antiretroviral and psychiatric medication adherence.
abstract: The contribution of bipolar disorder (BD), a prevalent serious mental illness characterized by impulsivity and mood instability, to antiretroviral (ART) and psychiatric medication adherence among HIV-infected (HIV+) individuals is unknown. We examined medication adherence among 44 HIV+/BD+ persons as compared to 33 demographically- and medically-comparable HIV+/BD- persons. Classification of adherent (≥ 90%) or non-adherent (<90%) based on proportion of correctly taken doses over 30 days was determined using electronic medication monitoring devices. HIV+/BD+ persons were significantly less likely to be ART adherent (47.7%) as compared to HIV+/BD- (90.9%) persons. Within the HIV+/BD+ group, mean psychiatric medication adherence was significantly worse than ART medication adherence, although there was a significant correlation between ART and psychiatric adherence levels. Importantly, 30-day ART adherence was associated with plasma virologic response among HIV+/BD+ individuals. Given the high overlap of HIV and BD, and the observed medication adherence difficulties for these persons, specialized adherence improvement interventions are needed.
authors: Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA. djmoore@ucsd.edu
authors: David J
authors: DJ
authors: Moore
authors: Carolina
authors: C
authors: Posada
authors: Mili
authors: M
authors: Parikh
authors: Miguel
authors: M
authors: Arce
authors: Florin
authors: F
authors: Vaida
authors: Patricia K
authors: PK
authors: Riggs
authors: Ben
authors: B
authors: Gouaux
authors: Ronald J
authors: RJ
authors: Ellis
authors: Scott L
authors: SL
authors: Letendre
authors: Igor
authors: I
authors: Grant
authors: J Hampton
authors: JH
authors: Atkinson
mesh_terms: D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D002140:California / Q000453:epidemiology; D015897:Comorbidity; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012367:RNA, Viral / Q000097:blood; D012959:Socioeconomic Factors; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents; D014150:Antipsychotic Agents; D012367:RNA, Viral