Understanding the Impact of Hazardous and Harmful Use of Alcohol and/or Other Drugs on ARV Adherence and Disease Progression.
The objective of this study was to understand the impact of hazardous and harmful use of alcohol and/or other drugs on ARV adherence and disease progression among HIV patients. A cross-sectional study design was used. A total of 1503 patients attending HIV clinics in Cape Town, South Africa were screened for problematic substance use. A sub-sample of 607 patients (303 patients who screened positive for problematic substance use and 304 who did not) participated in this study. Hazardous or harmful alcohol use and problematic drug use predicted missing and stopping ARVs which, in turn, was associated with a decrease in CD4 counts and more rapid HIV-disease progression and poorer health outcomes in people living with HIV/AIDS (PLWHA). The findings of this study underscore the need for an integrated approach to managing substance-use disorders in PLWHA.
Alcohol, Tobacco and other Drug Research Unit, Medical Research Council, Cape Town, South Africa.
Rehana
R
Kader
Centre for Social Science Research and Department of Sociology, University of Cape Town, Cape Town, South Africa.
Rajen
R
Govender
Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa.
Soraya
S
Seedat
Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, United States of America.
John Randy
JR
Koch
Alcohol, Tobacco and other Drug Research Unit, Medical Research Council, Cape Town, South Africa; Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa.
Charles
C
Parry
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active; D003710:Demography; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology*; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D019966:Substance-Related Disorders / Q000150:complications*