Homelessness and psychological distress as contributors to antiretroviral nonadherence in HIV-positive injecting drug users
Homelessness and psychological distress as contributors to antiretroviral nonadherence in HIV-positive injecting drug users
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DOI：
10.1089/apc.2005.19.326
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发表时间：
2005-05-01
影响因子：
4.9
通讯作者：
Valverde, E
中科院分区：
文献类型：
--
作者：
Waldrop-Valverde, D;Valverde, E
需要高度坚持使用抗逆转录病毒药物，以最大限度地提高治疗效益和抑制病毒。注射吸毒（IDU）与依从性水平下降、生活条件不稳定和心理健康问题有关。尽管艾滋病毒阳性注射吸毒者普遍存在这些不依从风险，但迄今为止几乎没有进行过研究来评估无家可归和心理痛苦对这一人群依从性的影响。本研究评估了住房状况（无家可归/边缘与非无家可归）和心理困扰，通过抑郁，焦虑和感知压力，自我报告的坚持58艾滋病毒阳性注射吸毒者的影响。这项研究的结果表明，无家可归/边缘居住的艾滋病毒阳性注射吸毒者报告的焦虑和感知的压力比他们的非无家可归的同行更高的水平。两组报告了相似的抑郁程度。然而，只有抑郁症与依从性显著相关。住房状况、药物或酒精使用以及其他人口统计学变量（包括性别、种族/民族和受教育年限）与依从性无关。这项研究还发现，无家可归/边缘居住的注射吸毒者的依从率相对较高，超过一半（63%）报告完美（100%）的依从水平。这项研究的结果表明，在评估患者抗逆转录病毒药物的准备时，目前的住房可能不需要成为主要关注的问题。相反，对于艾滋病毒阳性注射吸毒者来说，抑郁症可能是比无家可归更有效的不依从指标。
High levels of adherence to antiretroviral medications are required to maximize therapeutic benefits and viral suppression. Injecting drug use (IDU) is associated with decreased adherence levels, unstable living conditions and mental health problems. Despite the prevalence of these nonadherence risks in HIV-positive IDUs, little study has been conducted to date to assess the impact of homelessness and psychological distress on adherence in this population. The present study evaluated the effects of housing status (homeless/marginally housed versus nonhomeless) and psychological distress, measured via depression, anxiety and perceived stress, on self-reported adherence in 58 HIV-positive IDUs. Results from this study indicated that homeless/marginally housed HIV-positive IDUs reported higher levels of anxiety and perceived stress than their nonhomeless counterparts. The groups reported similar levels of depression. However, only depression was significantly related to adherence. Housing status, drug or alcohol use, and other demographic variables including gender, race/ethnicity, and years of education, were not associated with adherence. This study also found a relatively high rate of adherence in homeless/marginally housed IDUs with more than half (63%) reporting perfect (100%) adherence levels. Findings from this study suggest that when evaluating patient readiness for antiretroviral medications, current housing may not need to be the primary concern. Rather, depression may be a more potent indicator of nonadherence than homelessness for HIV-positive IDUs.