Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders.
Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders.
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DOI：
10.1080/09540120802001705
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发表时间：
2009-03
期刊：
影响因子：
1.7
通讯作者：
Bell J
中科院分区：
文献类型：
--
作者：
Mellins CA;Havens JF;McDonnell C;Lichtenstein C;Uldall K;Chesney M;Santamaria EK;Bell J
本文研究了艾滋病毒感染人群中与坚持抗逆转录病毒药物（ARVs）相关的因素，这些人群具有不坚持的高风险：患有精神和药物滥用障碍的个体。数据来自对1138名患有精神疾病和药物滥用障碍的hiv感染成人的多地点队列干预研究的基线访谈（基于使用DSM-IV标准的结构化精神病学研究访谈）。基线访谈记录了过去一年的精神疾病和药物使用情况、精神疾病和药物滥用严重程度、人口统计、过去三个月的服务利用情况、一般健康和与艾滋病毒有关的情况、自我报告的精神状况和自我报告的抗逆转录病毒药物使用情况。在参与者中，62%的人在基线时服用了抗逆转录病毒药物（n_542）， 45%服用抗逆转录病毒药物的人报告在过去三天内没有服用药物。不依从性报告与可检测的病毒载量显著相关（p < 01）。与不遵医嘱相关的因素有：目前滥用药物和酒精、心理困扰加剧、就诊次数减少、不遵医嘱服用精神药物以及自我报告的精神状况较差。心理困扰的增加与不依从性显著相关，与药物滥用无关（p < 0.05）。这些数据表明，必须解决患有这些合并症的成人艾滋病毒感染者的精神疾病和药物使用问题，以提高抗逆转录病毒药物的依从性。
This paper examines factors associated with adherence to antiretroviral medications (ARVs) in an HIV-infected population at high risk for non-adherence: individuals living with psychiatric and substance abuse disorders. Data were examined from baseline interviews of a multisite cohort intervention study of 1138 HIV-infected adults with both a psychiatric and substance abuse disorder (based on a structured psychiatric research interview using DSM-IV criteria). The baseline interview documented mental illness and substance use in the past year, mental illness and substance abuse severity, demographics, service utilization in the past three months, general health and HIV-related conditions, self-reported spirituality and self-reported ARV medication use. Among the participants, 62% were prescribed ARVs at baseline (n_542) and 45% of those on ARVs reported skipping medications in the past three days. Reports of non-adherence were significantly associated with having a detectable viral load (p < 01). The factors associated with non-adherence were current drug and alcohol abuse, increased psychological distress, less attendance at medical appointments, non-adherence to psychiatric medications and lower self-reported spirituality. Increased psychological distress was significantly associated with non-adherence, independent of substance abuse (p < .05). The data suggest that both mental illness and substance use must be addressed in HIV-infected adults living with these co-morbid illnesses to improve adherence to ARVs.
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影响因子：
4.9
作者：
Mellins, CA;Kang, E;Chesney, MA
通讯作者：
Chesney, MA
影响因子：
1.9
作者：
MCLELLAN, AT;LUBORSKY, L;OBRIEN, CP
通讯作者：
OBRIEN, CP
影响因子：
120.7
作者：
Ickovics, JR;Hamburger, ME;Moore, J
通讯作者：
Moore, J
DOI：
10.1016/s0899-3289(01)00064-5
发表时间：
2001-01-01
期刊：
JOURNAL OF SUBSTANCE ABUSE
影响因子：
--
作者：
Metsch, LR;Pereyra, M;Brewer, TH
通讯作者：
Brewer, TH
DOI：
10.1080/03610928008827941
发表时间：
1980-01-01
期刊：
COMMUNICATIONS IN STATISTICS PART A-THEORY AND METHODS
影响因子：
--
作者：
HOSMER, DW;LEMESHOW, S
通讯作者：
LEMESHOW, S