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- Title
Effects of drug abuse and mental disorders on use and type of antiretroviral therapy in HIV-infected persons.
- Authors
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
- Abstract
<bold>Objective: </bold>To distinguish the effects of drug abuse, mental disorders, and problem drinking on antiretroviral therapy (ART) and highly active ART (HAART) use.<bold>Design: </bold>Prospective population-based probability sample of 2,267 (representing 213,308) HIV-infected persons in care in the United States in early 1996.<bold>Measurements: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.
- Subjects
DRUG abuse; MENTAL illness; MEDICAL care of HIV-positive persons; HIV infections &; psychology; HIV infection complications; ANTI-HIV agents; INTRAVENOUS drug abuse; COMPARATIVE studies; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; SUBSTANCE abuse; LOGISTIC regression analysis; EVALUATION research; HIGHLY active antiretroviral therapy; DISEASE complications
- Publication
JGIM: Journal of General Internal Medicine, 2001, Vol 16, Issue 9, p625
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1046/j.1525-1497.2001.016009625.x