TITLE

Effects of drug abuse and mental disorders on use and type of antiretroviral therapy in HIV-infected persons

AUTHOR(S)
Turner, Barbara J.; Fleishman, John A.; Wenger, Neil; London, Andrew S.; Burnam, M. Audrey; Shapiro, Martin F.; Bing, Eric G.; Stein, Michael D.; Longshore, Douglas; Bozzette, Samuel A.; Turner, B J; Fleishman, J A; Wenger, N; London, A S; Burnam, M A; Shapiro, M F; Bing, E G; Stein, M D; Longshore, D; Bozzette, S A
PUB. DATE
September 2001
SOURCE
JGIM: Journal of General Internal Medicine;Sep2001, Vol. 16 Issue 9, p625
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Objective: To distinguish the effects of drug abuse, mental disorders, and problem drinking on antiretroviral therapy (ART) and highly active ART (HAART) use.Design: Prospective population-based probability sample of 2,267 (representing 213,308) HIV-infected persons in care in the United States in early 1996.Measurements: Self-reported ART from first (January 1997-July 1997) to second (August 1997-January 1998) follow-up interviews. Drug abuse/dependence, severity of abuse, alcohol use, and probable mental disorders assessed in the first follow-up interview. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) estimated from weighted models for 1) receipt of any ART, and 2) receipt of HAART among those on ART.Results: Of our study population, ART was reported by 90% and HAART by 61%. Over one third had a probable mental disorder and nearly half had abused any drugs, but drug dependence (9%) or severe abuse (10%) was infrequent. Any ART was less likely for persons with dysthymia (AOR, 0.74; CI, 0.58 to 0.95) but only before adjustment for drug abuse. After full adjustment with mental health and drug abuse variables, any ART was less likely for drug dependence (AOR, 0.58; CI, 0.34 to 0.97), severe drug abuse (AOR, 0.52; CI, 0.32 to 0.87), and HIV risk from injection drug use (AOR, 0.55; CI, 0.39 to 0.79). Among drug users on ART, only mental health treatment was associated with HAART (AOR, 1.57; CI, 1.11 to 2.08).Conclusions: Drug abuse-related factors were greater barriers to ART use in this national sample than mental disorders but once on ART, these factors were unrelated to type of therapy.
ACCESSION #
5528152

 

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