Methamphetamine use and neuropsychiatric factors are associated with antiretroviral non-adherence.
Methamphetamine use and neuropsychiatric factors are associated with antiretroviral non-adherence.
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DOI：
10.1080/09540121.2012.672718
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发表时间：
2012
期刊：
影响因子：
1.7
通讯作者：
Hnrc Group And The Tmarc Group
中科院分区：
文献类型：
--
作者：
Moore DJ;Blackstone K;Woods SP;Ellis RJ;Atkinson JH;Heaton RK;Grant I;Hnrc Group And The Tmarc Group
本研究评估了甲基苯丙胺（METH）对HIV+患者抗逆转录病毒（ART）依从性的影响，并检查了神经认知障碍和其他神经精神因素（即重度抑郁症（MDD）、反社会人格障碍（ASPD）和注意力缺陷障碍（ADHD））对抗逆转录病毒治疗依从性的影响。我们研究了经dsm - iv诊断有甲基苯丙胺滥用/依赖史的HIV阳性患者（HIV+/甲基苯丙胺+，n = 67）与没有甲基苯丙胺滥用/依赖史的HIV阳性患者（HIV+/甲基苯丙胺-，n = 50）的对比。辅助分析将这些人群与一小群目前滥用/依赖冰毒的HIV+/METH+人群（HIV+/CU METH+; n = 8）进行比较。不依从性定义为自我报告在过去4天内任何遗漏抗逆转录病毒治疗剂量。神经认知功能评估采用综合电池，涵盖七个神经心理学领域。终生冰毒诊断与血浆和脑脊液HIV RNA检测水平较高相关。当组合组（即，冰毒+和冰毒-参与者）时，单变量分析表明，同时发生的ADHD， ASPD和MDD预测抗逆转录病毒治疗不依从性（p <0.10；不是终生冰毒状态或神经认知障碍）。包含这些变量的显著多变量模型表明，在控制其他变量后，只有MDD能唯一预测抗逆转录病毒治疗不依从（p<0.05）。辅助分析表明，当前冰毒使用者（30天内使用）的依从性（不依从率为50%）明显低于终生冰毒+使用者和HIV+/冰毒参与者，神经认知障碍与不依从性相关（p <0.05）。甲基苯丙胺使用障碍与更糟糕的艾滋病毒疾病结局和抗逆转录病毒药物不依从性有关。干预措施往往只针对药物使用行为，以提高抗逆转录病毒治疗的效果；然而，除了针对药物使用行为，改善抗逆转录病毒治疗依从性的干预措施可能还需要解决共存的神经精神因素和认知障碍，以改善抗逆转录病毒治疗药物的服用。
The present study assesses the impact of methamphetamine (METH) on antiretroviral (ART) adherence among HIV+ persons, as well as examines the contribution of neurocognitive impairment and other neuropsychiatric factors (i.e., major depressive disorder (MDD), Antisocial Personality Disorder (ASPD), and Attention Deficit Disorder (ADHD)) for ART nonadherence. We examined HIV+ persons with DSM-IV-diagnosed lifetime history of METH abuse/dependence (HIV+/METH+; n = 67) as compared to HIV+ participants with no history of METH abuse/dependence (HIV+/METH−; n = 50). Ancillary analyses compared these groups with a small group of HIV+/METH+ persons with current METH abuse/dependence (HIV+/CU METH+; n = 8). Nonadherence was defined as self-report of any skipped ART dose in the last four days. Neurocognitive functioning was assessed with a comprehensive battery, covering seven neuropsychological domains. Lifetime METH diagnosis was associated with higher rates of detectable levels of plasma and CSF HIV RNA. When combing groups (i.e., METH+ and METH− participants), univariate analyses indicated co-occurring ADHD, ASPD, and MDD predicted ART nonadherence (p’s<0.10; not lifetime METH status or neurocognitive impairment). A significant multivariable model including these variables indicated that only MDD uniquely predicted ART nonadherence after controlling for the other variables (p<0.05). Ancillary analyses indicated that current METH users (use within 30 days) were significantly less adherent (50% prevalence of nonadherence) than lifetime METH+ users and HIV+/METH-participants, and that neurocognitive impairment was associated with nonadherence (p’s<0.05). METH use disorders are associated with worse HIV disease outcomes and ART medication nonadherence. Interventions often target substance use behaviors alone to enhance antiretroviral treatment outcomes; however, in addition to targeting substance use behaviors, interventions to improve ART adherence may also need to address coexisting neuropsychiatric factors and cognitive impairment to improve ART medication taking.
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DOI：
10.1017/s1355617704102130
发表时间：
2004-05-01
影响因子：
2.6
作者：
Heaton, RK;Marcotte, TD;Grant, I
通讯作者：
Grant, I
DOI：
10.1097/00126334-200212153-00013
发表时间：
2002-12-15
影响因子：
3.6
作者：
Bouhnik, AD;Chesney, M;Spire, B
通讯作者：
Spire, B
影响因子：
4.4
作者：
Coady, Micaela H.;Latka, Mary H.;Garfein, Richard S.
通讯作者：
Garfein, Richard S.
影响因子：
6.4
作者：
Ellis, RJ;Childers, ME;Grant, I
通讯作者：
Grant, I
影响因子：
3.9
作者：
Burton, Catherine L.;Strauss, Esther;Hunter, Michael A.
通讯作者：
Hunter, Michael A.