title: Substance Use and Adherence Among People Living with HIV/AIDS Receiving cART in Latin America.
abstract: This cross-sectional study describes substance use prevalence and its association with combination antiretroviral therapy (cART) adherence among 3343 individuals receiving care at HIV clinics in Argentina, Brazil, Chile, Honduras, Mexico, and Peru. A rapid screening tool evaluated self-reported 7-day recall of alcohol, marijuana, cocaine, heroin, and methamphetamine use, and missed cART doses. Overall, 29.3 % individuals reported having ≥1 alcoholic drinks, 5.0 % reported any illicit drug use and 17.0 % reported missed cART doses. In the logistic regression model, compared to no substance use, alcohol use [adjusted odds ratio (AOR) = 2.46, 95 % confidence interval (CI): 1.99-3.05], illicit drug use (AOR = 3.57, 95 % CI: 2.02-6.30), and using both alcohol and illicit drugs (AOR = 4.98, 95 % CI: 3.19-7.79) were associated with missed cART doses. The associations between substance use and likelihood of missing cART doses point to the need of targeting alcohol and illicit drug use to improve adherence among people living with HIV in Latin America.
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas - FIOCRUZ, Av. Brasil 4365, Rio de Janeiro, CEP 21040-360, Brazil. raqueldeboni@gmail.com.
authors.forename: Raquel B
authors.initials: RB
authors.lastname: De Boni
authors.affiliation: Vanderbilt University, Nashville, USA.
authors.forename: Bryan E
authors.initials: BE
authors.lastname: Shepherd
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas - FIOCRUZ, Av. Brasil 4365, Rio de Janeiro, CEP 21040-360, Brazil.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Grinsztejn
authors.affiliation: Fundación Huésped, Buenos Aires, Argentina.
authors.forename: Carina
authors.initials: C
authors.lastname: Cesar
authors.affiliation: Fundación Arriaran, Santiago, Chile.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cortés
authors.affiliation: Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Denis
authors.initials: D
authors.lastname: Padgett
authors.affiliation: Instituto Hondureno de Seguridad Social and Hospital Escuela, Tegucigalpa, Honduras.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gotuzzo
authors.affiliation: Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Belaunzarán-Zamudio
authors.affiliation: Vanderbilt University, Nashville, USA.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Rebeiro
authors.affiliation: Vanderbilt University, Nashville, USA.
authors.forename: Stephany N
authors.initials: SN
authors.lastname: Duda
authors.affiliation: Vanderbilt University, Nashville, USA.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: McGowan
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000453:epidemiology*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D013287:Illicit Drugs; D007843:Latin America; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016017:Odds Ratio; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D019380:Anti-HIV Agents; D013287:Illicit Drugs
keywords: Adherence; HIV/AIDS; Latin America; Substance use