title: Medication persistence of HIV-infected drug users on directly administered antiretroviral therapy.
abstract: Patient and regimen persistence in HIV-infected drug users are largely unknown. We evaluated patterns of medication non-persistence among HIV-infected drug users enrolled in a prospective, 6-month randomized controlled trial of directly administered antiretroviral therapy (DAART). Medication-taking behavior was assessed via direct observation and MEMS data. Of 74 participants who initiated DAART, 59 (80%) subjects were non-persistent with medication for 3 or more consecutive days. Thirty-one participants (42%) had 2 or more episodes of non-persistence. Higher depressive symptoms were strongly associated with non-persistence episodes of ≥ 3 days (AOR: 17.4, P = 0.02) and ≥ 7 days AOR: 5.4, P = 0.04). High addiction severity (AOR 3.2, P = 0.03) was correlated with non-persistence ≥ 7 days, and injection drug use (AOR: 15.2, P = 0.02) with recurrence of non-persistence ≥ 3 days. Time to regimen change was shorter for NNRTI-based regimens compared to PI-based ones (HR: 3.0, P = 0.03). There was no significant association between patterns of patient non-persistence and virological outcomes.
authors: Butler Hospital/Alpert Medical School of Brown University, Providence, RI, USA.
authors: Eileen C
authors: EC
authors: Ing
authors: Jason W
authors: JW
authors: Bae
authors: Duncan Smith-Rohrberg
authors: DS
authors: Maru
authors: Frederick L
authors: FL
authors: Altice
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D016739:Behavior, Addictive; D018791:CD4 Lymphocyte Count; D003237:Connecticut; D023801:Directly Observed Therapy; D055030:Drug Users / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007407:Interviews as Topic; D053208:Kaplan-Meier Estimate; D008297:Male; D055118:Medication Adherence; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000097:blood; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral