Impact of Use of Alcohol and Illicit Drugs by AIDS Patients on Adherence to Antiretroviral Therapy in Bahia, Brazil
| Autor: | Marcio P. Santos, Carlos Brites, Maria de Lourdes Dourado, Celia Teixeira |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Demographics Anti-HIV Agents Substance-Related Disorders Immunology CD4-CD8 Ratio Program activities Human immunodeficiency virus (HIV) medicine.disease_cause Medication Adherence Plasma viral load Young Adult Surveys and Questionnaires Virology Internal medicine Humans Medicine Psychiatry Aged Acquired Immunodeficiency Syndrome Aids patients business.industry Middle Aged Viral Load Antiretroviral therapy Alcoholism Logistic Models Infectious Diseases HIV-1 Female business Brazil |
| Zdroj: | AIDS Research and Human Retroviruses. 29:799-804 |
| ISSN: | 1931-8405 0889-2229 |
| DOI: | 10.1089/aid.2012.0296 |
| Popis: | Use of alcohol and illicit drugs is a common finding among HIV-infected individuals, but there are many open questions about its impact on adherence to antiretroviral therapy and virological outcomes. Our study aimed to evaluate the impact of the use of alcohol and illicit drugs on the adherence to antiretroviral therapy (ART) among patients starting ART in Salvador, Brazil. We followed up 144 AIDS patients initiating ART for a 6-month period. At baseline, they were interviewed about demographics, behavior, and use of illicit drugs and alcohol. All of them had HIV-1 RNA plasma viral load and CD4(+)/CD8(+) cells count measured before starting therapy. After 60 days of treatment they were asked to answer a new questionnaire on adherence to ART. All patients were monitored during the following months, and new CD4(+) cell count/HIV-1 RNA plasma viral load determinations were performed after 6 months of therapy. Optimal adherence to therapy was defined by self-reported questionnaire, by 95% use of prescribed drug doses, and by using plasma HIV-1 RNA viral load as a biological marker. A total of 61 (42.4%) patients reported alcohol use, 7 (4.9%) used illicit drugs, and 17 (11.8%) used both alcohol and illicit drugs. Being in a steady relationship was protective to nonadherence (95% CI: 0.18-0.84). Missing more than two medical visits was also associated with a 68% higher likelihood of nonadherence (95% CI: 0.10-1.02). After logistic regression we detected a higher risk of nonadherence for patients declaring use of alcohol plus illicit drugs (odds ratio=6.0; 95% CI: 1.78-20.28) or high-intensity use of alcohol (odds ratio=3.29; 95% CI: 1.83-5.92). AIDS patients using alcohol and/or illicit drugs are socially vulnerable, and need specific and flexible programs, combining mental health care, harm reduction strategies, and assisted drug therapy to maximize the chances of successful use of ART. |
| Databáze: | OpenAIRE |
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