title: The Demand for Antiretroviral Drugs in the Illicit Marketplace: Implications for HIV Disease Management Among Vulnerable Populations.
abstract: The diversion of antiretroviral medications (ARVs) has implications for the integrity and success of HIV care, however little is known about the ARV illicit market. This paper aimed to identify the motivations for buying illicit ARVs and to describe market dynamics. Semi-structured interviews (n = 44) were conducted with substance-involved individuals living with HIV who have a history of purchasing ARVs on the street. Grounded theory was used to code and analyze interviews. Motivations for buying ARVs on the illicit market were: to repurchase ARVs after having diverted them for money or drugs; having limited access or low quality health care; to replace lost or ruined ARVs; and to buy a back-up stock of ARVs. This study identified various structural barriers to HIV treatment and ARV adherence that incentivized ARV diversion. Findings highlight the need to improve patient-provider relationships, ensure continuity of care, and integrate services to engage and retain high-needs populations.
authors.affiliation: Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 2 NE 40th Street, Suite 404, Miami, FL, 33137, USA, ktsuyuki@nova.edu.
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Tsuyuki
authors.forename: Hilary L
authors.initials: HL
authors.lastname: Surratt
authors.forename: Maria A
authors.initials: MA
authors.lastname: Levi-Minzi
authors.forename: Catherine L
authors.initials: CL
authors.lastname: O'Grady
authors.forename: Steven P
authors.initials: SP
authors.lastname: Kurtz
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000191:economics / Q000627:therapeutic use*; D003132:Commerce / Q000191:economics*; D019468:Disease Management; D011307:Drug Prescriptions; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007407:Interviews as Topic; D009042:Motivation; D015999:Multivariate Analysis; D036301:Qualitative Research; D012309:Risk-Taking; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D011795:Surveys and Questionnaires; D047568:Unsafe Sex; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
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