Abstract
BackgroundOpiate substitution treatment has been associated with better adherence to lifesaving antiretroviral medications, but the impact of other substance abuse treatment on adherence is unknown.FindingsIn this study, 215 patients who had been in adherence-focused research studies provided electronically-measured adherence data and a measure of whether the patient had recently been in substance abuse treatment. Recent engagement in substance abuse treatment was independently associated with significantly higher adherence, after covarying for recent substance use and other factors potentially affecting adherence.ConclusionsThe findings suggest that substance abuse treatment is associated with better adherence. Potential mechanisms by which substance abuse treatment improves adherence, such as more stability or more future-orientation, require further study.
Highlights
Opiate substitution treatment has been associated with better adherence to lifesaving antiretroviral medications, but the impact of other substance abuse treatment on adherence is unknown
HIV-positive patients who use drugs or alcohol may be referred to standard substance abuse treatment with the hope that medication adherence will improve with abstinence
* Correspondence: Marc.Rosen@Yale.edu 1Department of Psychiatry, Yale University School of Medicine, New Haven, CT; VA Connecticut Healthcare System, West Haven, CT 06516, USA Full list of author information is available at the end of the article have shown even better adherence over time than with those receiving opiate substitution alone [7,8]. It is not known whether enrollment in substance abuse treatments other than opioid substitution is associated with better adherence
Summary
There are considerable data suggesting that current substance abuse is associated with both worse adherence to antiretroviral medications and worse attendance at HIV treatment visits [1]. Among substance abuse treatments, only opiate substitution treatment has consistently been associated with better adherence, as summarized in a 2008 meta-analysis [2]. Both buprenorphine [3,4] and methadone maintenance [5,6] have been consistently associated with better adherence. Patients who received both opiate substitution treatment and directly observed therapy. It is not known whether enrollment in substance abuse treatments other than opioid substitution is associated with better adherence. We used data pooled from two clinical trials of adherence-focused interventions to test the hypotheses that HIV-infected people who had recently been in substance abuse treatment would have better antiretroviral adherence, and better adherence over time, than those who had not had recent substance abuse treatment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
