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Medication Persistence of HIV-infected Drug Users on Directly Administered Antiretroviral Therapy

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Abstract

Patient and regimen persistence in HIV-infected drug users are largely unknown. We evaluated patterns of medication non-persistence among HIV-infected drug users enrolled in a prospective, 6-month randomized controlled trial of directly administered antiretroviral therapy (DAART). Medication-taking behavior was assessed via direct observation and MEMS data. Of 74 participants who initiated DAART, 59 (80%) subjects were non-persistent with medication for 3 or more consecutive days. Thirty-one participants (42%) had 2 or more episodes of non-persistence. Higher depressive symptoms were strongly associated with non-persistence episodes of ≥ 3 days (AOR: 17.4, P = 0.02) and ≥ 7 days AOR: 5.4, P = 0.04). High addiction severity (AOR 3.2, P = 0.03) was correlated with non-persistence ≥ 7 days, and injection drug use (AOR: 15.2, P = 0.02) with recurrence of non-persistence ≥ 3 days. Time to regimen change was shorter for NNRTI-based regimens compared to PI-based ones (HR: 3.0, P = 0.03). There was no significant association between patterns of patient non-persistence and virological outcomes.

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Acknowledgments

The authors would like to acknowledge the National Institutes on Drug Abuse (R01 DA13805) for funding this study and career development award for FLA (K24 DA 0170720). DSRM is a Global Health Equity Fellow at Brigham and Women’s Hospital. The funding sources played no role in the design of the study, data collection, analysis or interpretation of results or in the writing of the report. We would like to thank Paula Dellamura for administrative support. Most importantly, we would like to thank the research staff and the study participants who dedicated time and energy to make this research possible. Without their help, this research would not have been possible.

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Authors and Affiliations

  1. Butler Hospital/Alpert Medical School of Brown University, Providence, RI, USA

    Eileen C. Ing

  2. Section of Infectious Diseases, Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510-2283, USA

    Jason W. Bae & Duncan Smith-Rohrberg Maru

  3. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Duncan Smith-Rohrberg Maru

  4. Department of Medicine, Children’s Hospital of Boston, Boston, MA, USA

    Duncan Smith-Rohrberg Maru

  5. Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510-2283, USA

    Frederick L. Altice

  6. Division of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA

    Frederick L. Altice

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  1. Eileen C. Ing
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  2. Jason W. Bae
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Correspondence to Frederick L. Altice.

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Ing, E.C., Bae, J.W., Maru, D.SR. et al. Medication Persistence of HIV-infected Drug Users on Directly Administered Antiretroviral Therapy. AIDS Behav 17, 113–121 (2013). https://doi.org/10.1007/s10461-011-0082-0

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