TY - JOUR
T1 - Polysubstance use and adherence to antiretroviral treatment in the Miami Adult Studies on HIV (MASH) cohort
AU - Degarege, Abraham
AU - Krupp, Karl
AU - Tamargo, Javier
AU - Martinez, Sabrina Sales
AU - Campa, Adriana
AU - Baum, Marianna
N1 - Funding Information:
This work was supported by National Institute on Drug Abuse [grant number U01DA040381] and National Institute on Alcohol Abuse and Alcoholism [grant number R01AA018011]. The funders have not played a role in designing, data collection, and analysis, preparation, and submission of this manuscript for publication. The authors would like to thank the study participants for their time; this study would not be possible without them. The authors are also grateful to Baum MASH Cohort Research Group for their contribution during data collection.
Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Evidence for a relationship between polysubstance use, depression, and adherence to antiretroviral therapy (ART) is limited. The objectives of this study were to examine the associations of depression, illicit drug, and alcohol use with adherence to ART. People living with HIV (PLHIV) from the Miami Adult Studies on HIV cohort were asked about the number of doses of their ART medication missed to assess ART adherence. Harmful alcohol drinking was evaluated using the Alcohol Use Disorders Identification Test and illicit substance use assessed with self-report and urine screen. The Center for Epidemiologic Studies Depression Scale was used to assess depression symptoms. Of 391 PLHIV, 16.6% missed at least one dose (range:1–4) in the past four days. Cocaine/crack, opiate use, and depression were significantly independently associated with a greater mean number of doses missed. The mean number of doses missed was significantly greater among participants who used alcohol in combination with cocaine/crack, marijuana, and tobacco compared to non-users. In conclusion, polysubstance use increased the risk for poor ART adherence among PLHIV. The use of cocaine/crack or opiates individually and depressive symptoms also promote poor ART adherence. An integrated approach targeting substance disorders and depression may help achieve better ART adherence.
AB - Evidence for a relationship between polysubstance use, depression, and adherence to antiretroviral therapy (ART) is limited. The objectives of this study were to examine the associations of depression, illicit drug, and alcohol use with adherence to ART. People living with HIV (PLHIV) from the Miami Adult Studies on HIV cohort were asked about the number of doses of their ART medication missed to assess ART adherence. Harmful alcohol drinking was evaluated using the Alcohol Use Disorders Identification Test and illicit substance use assessed with self-report and urine screen. The Center for Epidemiologic Studies Depression Scale was used to assess depression symptoms. Of 391 PLHIV, 16.6% missed at least one dose (range:1–4) in the past four days. Cocaine/crack, opiate use, and depression were significantly independently associated with a greater mean number of doses missed. The mean number of doses missed was significantly greater among participants who used alcohol in combination with cocaine/crack, marijuana, and tobacco compared to non-users. In conclusion, polysubstance use increased the risk for poor ART adherence among PLHIV. The use of cocaine/crack or opiates individually and depressive symptoms also promote poor ART adherence. An integrated approach targeting substance disorders and depression may help achieve better ART adherence.
KW - ART
KW - HIV
KW - MASH
KW - Polysubstance
KW - depression
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U2 - 10.1080/09540121.2021.1896660
DO - 10.1080/09540121.2021.1896660
M3 - Article
C2 - 33663276
AN - SCOPUS:85129999274
SN - 0954-0121
VL - 34
SP - 639
EP - 646
JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
IS - 5
ER -