Psychiatric and Social Barriers to HIV Medication Adherence in a Triply Diagnosed Methadone Population
- 1 December 2003
- journal article
- research article
- Published by Mary Ann Liebert Inc in AIDS Patient Care and STDs
- Vol. 17 (12), 635-644
- https://doi.org/10.1089/108729103771928690
Abstract
Although antiretrovirals can prolong life, medication adherence also poses a constant challenge for HIV-infected individuals because the success of antiretroviral regimens demands nearly perfect adherence to medications. This paper describes the psychiatric and social barriers to adherence in a convenience sample of HIV-positive clients in methadone treatment in the Bronx, New York. The study sample was part of a national study of HIV treatment adherence and health care utilization among triply diagnosed populations, the HIV/AIDS Treatment Adherence Health Outcomes and Cost Study. The triply diagnosed study sample is defined here as HIV-infected individuals who screened into the study with at least one psychiatric diagnosis in addition to opioid dependence on agonist therapy (methadone treatment) and at least one substance use diagnosis. Interviewers utilized modified versions of the Structured Clinical Interview for DSM-IV Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), and the Addiction Severity Index (ASI-Lite), among a battery of Cost Study instruments. Results showed that within this sample, borderline personality disorder was significantly associated with nonadherence to HIV medications. A related finding showed a significant relationship between serious social/family problems and nonadherence. These findings build on previous research on the impact of psychiatric illness on HIV medication adherence and suggest that psychiatric assessment and treatment options be linked to adherence interventions.Keywords
This publication has 32 references indexed in Scilit:
- The effect of changes in depression on health related quality of life (HRQoL) in HIV infectionGeneral Hospital Psychiatry, 2002
- Antiretroviral Therapy Adherence and Viral Suppression in HIV‐Infected Drug Users: Comparison of Self‐Report and Electronic MonitoringClinical Infectious Diseases, 2001
- Predictors of Nonadherence to HIV‐Related Medication Regimens During Methadone StabilizationThe American Journal on Addictions, 2001
- Factors Affecting Adherence to Antiretroviral TherapyClinical Infectious Diseases, 2000
- Adherence to HIV combination therapySocial Science & Medicine, 2000
- Quality of life in asymptomatic- and symptomatic HIV infected patients in a trial of ritonavir/saquinavir therapyAIDS, 2000
- Predictors of Self-Reported Adherence in Persons Living with HIV DiseaseAIDS Patient Care and STDs, 1999
- Treatment of Depressive Symptoms in Human Immunodeficiency Virus–Positive PatientsArchives of General Psychiatry, 1998
- Counselling gay men with multiple loss and survival problems: The bereavement group as a transitional objectAIDS Care, 1998
- Determinants of compliance with antiretroviral therapy in patients with human immunodeficiency virus: Prospective assessment with implications for enhancing complianceAIDS Care, 1996