TITLE

Psychiatric and Social Barriers to HIV Medication Adherence in a Triply Diagnosed Methadone Population

AUTHOR(S)

Palmer, Nancy B.; Salcedo, Jesus; Miller, Alec L.; Winiarski, Mark; Arno, Peter

PUB. DATE

December 2003

SOURCE

AIDS Patient Care & STDs;Dec2003, Vol. 17 Issue 12, p635

SOURCE TYPE

Academic Journal

DOC. TYPE

Article

ABSTRACT

Although antiretrovirals can prolong life, medication adherence also poses a constant challenge for HIV-infected individuals because the success of antiretroviral regimens demands nearly perfect adherence to medications. This paper describes the psychiatric and social barriers to adherence in a convenience sample of HIV-positive clients in methadone treatment in the Bronx, New York. The study sample was part of a national study of HIV treatment adherence and health care utilization among triply diagnosed populations, the HIV/AIDS Treatment Adherence Health Outcomes and Cost Study. The triply diagnosed study sample is defined here as HIV-infected individuals who screened into the study with at least one psychiatric diagnosis in addition to opioid dependence on agonist therapy (methadone treatment) and at least one substance use diagnosis. Interviewers utilized modified versions of the Structured Clinical Interview for DSM-IV Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), and the Addiction Severity Index (ASI-Lite), among a battery of Cost Study instruments. Results showed that within this sample, borderline personality disorder was significantly associated with nonadherence to HIV medications. A related finding showed a significant relationship between serious social/family problems and nonadherence. These findings build on previous research on the impact of psychiatric illness on HIV medication adherence and suggest that psychiatric assessment and treatment options be linked to adherence interventions.

ACCESSION #

11874109

Tags: HIV infections -- Treatment;  ANTIRETROVIRAL agents;  PATIENT compliance;  HIV-positive persons;  LENTIVIRUS infections;  METHADONE maintenance

 

Related Articles

• Eliminating Persistent HIV Infection: Getting to the End of the Rainbow. Margolis, David M.; Archin, Nancie M. // Journal of Infectious Diseases;6/15/2007, Vol. 195 Issue 12, p1734 

  This article comments on challenges that the medical fraternity faces to eradicate established HIV infection. The article makes specific reference to the study "Decay of the HIV Reservoir in Patients Receiving of Antiretroviral Therapy for Extended Periods: Implications for Eradication of...

• Nonadherence to Antiretroviral Therapy in HIV-Positive Patients in Costa Rica. Stout, Brian Douglas; Leon, Maria Paz; Niccolai, Linda M. // AIDS Patient Care & STDs;May2004, Vol. 18 Issue 5, p297 

  A cross-sectional study was performed among seropositive individuals who sought HIV treatment at an outpatient clinic in San Jose, Costa Rica, to determine the prevalence, predictors, and reasons for nonadherence to antiretroviral. A structured, face-to-face interview was administered to 88...

• Adherence to HAART Among HIV-Infected Persons in Rural Louisiana. Mohammed, Hamish; Kieltyka, Lyn; Richardson-Alston, Gwangi; Magnus, Manya; Fawal, Hala; Vermund, Sten H.; Rice, Janet; Kissinger, Patricia // AIDS Patient Care & STDs;May2004, Vol. 18 Issue 5, p289 

  The purpose of this study was to examine factors associated with nonadherence to highly active antiretroviral therapy (HAART) in patients seen in HIV clinics throughout nonurban Louisiana. A convenience sample of 273 patients from 8 areas in nonurban Louisiana were interviewed to obtain...

• Where to Start?  // Guide;May2006, Vol. 26 Issue 5, p77 

  The article states that the use of antiretroviral therapy for HIV patients still faces challenges, such as major adverse effects, difficulties of patients to comply with treatment regimen, and antiretroviral drug resistance. Patients are encouraged to visit www.hivinsite.org to obtain...

• NEAR-PERFECT ADHERENCE NEEDED TO SUPPRESS CELL-ASSOCIATED HIV. Carter, Michael // HIV Australia;2012, Vol. 10 Issue 2, p49 

  The article focuses on a Netherlands report of investigators in the online edition of the "Journal of Infectious Diseases" showing the need of complete adherence to antiretroviral therapy (ART) in ensuring suppression of cell-associated HIV. The report has examined an average of 40 people taking...

• When and why to start antiretroviral therapy? Gatell, Jose M. // Journal of Antimicrobial Chemotherapy (JAC);Mar2010, Vol. 65 Issue 3, p383 

  The question about when to start antiretroviral therapy in HIV-1-infected patients has been debated since the discovery of the first antiretroviral agent (zidovudine) back in 1986 and has been fuelled by the introduction of highly active combined antiretroviral therapy (cART) 10 years later in...

• Letter to the Editor: Modified Directly Observed Therapy: Sustained Self-Reported Adherence and HIV Health Status. Mitty, Jennifer A.; Huang, Delphine; Loewenthal, Helen G.; MacLeod, Cynthia; Thompson, Lara; Bazerman, Lauri B. // AIDS Patient Care & STDs;Dec2007, Vol. 21 Issue 12, p897 

  The article presents a medical research in the U.S. on a modified directly observed therapy (MDOT) in HIV patients. The purpose of the study is to reports on the long-term impact of MDOT on adherence as well as clinical markers among individuals who participated in an MDOT program. The study...

• Theory-Guided, Empirically Supported Avenues for Intervention on HIV Medication Nonadherence: Findings from the Healthy Living Project. Johnson, Mallory O.; Catz, Sheryl L.; Remien, Robert H.; Rotheram-Borus, Mary Jane; Morin, Stephen F.; Charlebois, Edwin; Gore-Felton, Cheryl; Goldsten, Rise B.; Wolfe, Hannah; Lightfoot, Marguerita; Chesney, Margaret A. // AIDS Patient Care & STDs;Dec2003, Vol. 17 Issue 12, p645 

  Objectives: Adherence to antiretroviral therapy (ART) remains a challenge in efforts to maximize HIV treatment benefits. Previous studies of antiretroviral adherence are limited by low statistical power, homogeneous samples, and biased assessment methods. Based on Social Action Theory and using...

• Treatment Options for HIV-Associated Tuberculosis. Onyebujoh, Philip Chukwuka; Ribeiro, Isabela; Whalen, Christopher Curtis // Journal of Infectious Diseases;8/15/2007 Supplement, Vol. 196, pS35 

  The vicious interaction between the human immunodeficiency virus (HIV) infection and tuberculosis (TB) pandemics poses special challenges to national control programs and individual physicians. Although recommendations for the treatment of TB in HIV-infected patients do not significantly differ...

Read the Article