title: Adherence to antiretroviral medications among persons who inject drugs in transitional, low and middle income countries: an international systematic review.
abstract: Adherence to antiretroviral (ART) medication is vital to reducing morbidity and mortality among HIV positive persons. People who inject drugs (PWID) are at high risk for HIV infection in transitional/low/middle income countries (TLMIC). We conducted a systematic review of studies reporting adherence to ART among persons with active injection drug use and/or histories of injection drug use in TLMIC. Meta-regression was performed to examine relationships between location, adherence measurements, and follow-up period. Fifteen studies were included from seven countries. Adherence levels ranged from 33 to 97 %; mean weighted adherence was 72 %. ART adherence was associated with different methods of measuring adherence and studies conducted in Eastern Europe and East Asia. The great heterogeneity observed precludes generalization to TLMIC as a whole. Given the critical importance of ART adherence more research is needed on ART adherence among PWID in TLMIC, including the use of standardized methods for reporting adherence to ART.
authors.affiliation: The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 160 Water Street, New York, NY, 10038, USA, jfeelemyer@chpnet.org.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Feelemyer
authors.forename: Don
authors.initials: D
authors.lastname: Des Jarlais
authors.forename: Kamyar
authors.initials: K
authors.lastname: Arasteh
authors.forename: Anneli
authors.initials: A
authors.lastname: Uusküla
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D055030:Drug Users / Q000706:statistics & numerical data*; D004957:Estonia / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D007214:Indonesia / Q000453:epidemiology; D012426:Russia / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014744:Vietnam / Q000453:epidemiology; D016903:Drug Monitoring