The impact of illicit drug use and substance abuse treatment on adherence to HAART
The impact of illicit drug use and substance abuse treatment on adherence to HAART
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DOI：
10.1080/09540120701351888
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发表时间：
2007-10-01
影响因子：
1.7
通讯作者：
Gebo, K. A.
中科院分区：
文献类型：
--
作者：
Hicks, P. L.;Mulvey, K. P.;Gebo, K. A.
高度坚持高效抗逆转录病毒治疗（HAART）对于HIV患者的病毒学抑制和更长的生存期至关重要。我们检查了药物滥用治疗的影响，目前与以前的药物使用，以及危险/酗酒对HAART依从性的影响。2003年期间，对659名在初级保健中接受抗逆转录病毒治疗的艾滋病毒患者进行了访谈。依从性定义为>= 95%的抗逆转录病毒药物依从性。目前的药物使用者在过去六个月内使用非法药物和/或危险/酗酒，而以前的使用者至少有六个月没有使用药物。对HAART治疗依从性的Logistic回归分析包括人口统计学、临床和药物滥用变量。67%的样本报告95%或更高的依从性。然而，目前的用户（60%）比以前的用户（68%）或从未使用过的用户（77%）更不可能坚持使用。在多变量分析中，药物滥用治疗的前使用者与从未使用者一样坚持HAART治疗(调整优势比(AOR) = 0.82；P > 0.5)。相比之下，最近未接受药物滥用治疗的前吸毒者的依从性明显低于从未使用过的吸毒者（AOR = 0.61; p = 0.05）。无论药物滥用治疗如何，当前药物使用者的依从性明显低于从未使用过的药物使用者（p < 0.01）。药物滥用治疗与当前和以前的药物使用状况相互作用，影响HAART的依从性。药物滥用治疗可改善前药物使用者的HAART依从性。
High levels of adherence to highly active antiretroviral therapy (HAART) are essential for virologic suppression and longer survival in patients with HIV. We examined the effects of substance abuse treatment, current versus former substance use, and hazardous/binge drinking on adherence to HAART. During 2003, 659 HIV patients on HAART in primary care were interviewed. Adherence was defined as >= 95% adherence to all antiretroviral medications. Current substance users used illicit drugs and/or hazardous/binge drinking within the past six months, while former users had not used substances for at least six months. Logistic regression analyses of adherence to HAART included demographic, clinical and substance abuse variables. Sixty-seven percent of the sample reported 95% adherence or greater. However, current users (60%) were significantly less likely to be adherent than former (68%) or never users (77%). In multivariate analysis, former users in substance abuse treatment were as adherent to HAART as never users (Adjusted Odds Ratio (AOR) = 0.82; p > 0.5). In contrast, former users who had not received recent substance abuse treatment were significantly less adherent than never users (AOR = 0.61; p = 0.05). Current substance users were significantly less adherent than never users, regardless of substance abuse treatment (p < 0.01). Substance abuse treatment interacts with current versus former drug use status to affect adherence to HAART. Substance abuse treatment may improve HAART adherence for former substance users.