Antiretroviral medication diversion in South Florida: Prescription types and motivations

Abstract

This research was supported by NIH Grant Number R01DA023157. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We gratefully acknowledge Dr. James A. Inciardi. •The Miami area had the highest rate of new HIV infections in the nation in 2011 at 46 cases per 100,000 population (CDC, 2013). •ARV medication diversion in South Florida includes HIV positive individuals who sell or trade their prescribed ARV medications. •Little is known specifically about motivations for ARV medication diversion and commonly diverted ARV medications. •ARV diversion has potentially significant public health consequences including compromised adherence to needed ARV medication regimens. •The market for selling ARV medications appears to be established, with 80% recently selling to pill brokers, and the study participants selling an average of seven times. •Diverters do not consistently adhere to their own ARV regimens (only 37.8% report 95% adherence). •Diverters of ARV medication have substance related economic challenges which could be motivations for selling the medication: •70.1% reported they first diverted for money for drugs or alcohol. •42.4% earned less than $500 a month, however the mean monthly spending on alcohol and drugs is $485 a month. • In addition, many have high levels of unmet basic needs: •51.8% reported recent food or housing insecurity. •46.2% are unemployed.