Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users

Julia H. Arnsten, Xuan Li, Yuko Mizuno, Amy Ruth Knowlton, Marc N. Gourevitch, Kathleen Handley, Kelly R. Knight, Lisa R. Metsch

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Active drug use is often associated with poor adherence, but few studies have determined psychosocial correlates of adherence in injection drug users (IDUs). METHODS: Of 1161 Intervention for Seropositive Injectors-Research and Evaluation study enrollees, 636 were taking antiretrovirals. We assessed self-reported adherence to self-reported antiretroviral regimens and medication errors, which we defined as daily doses that were inconsistent with standard or alternative antiretroviral prescriptions. RESULTS: Most subjects (75%, n = 477) self-reported good (≥90%) adherence, which was strongly associated with an undetectable viral load. Good adherence was independently associated with being a high school graduate, not sharing injection equipment, fewer depressive symptoms, positive attitudes toward antiretrovirals, higher self-efficacy for taking antiretrovirals as prescribed, and greater sense of responsibility to protect others from HIV. Medication errors were made by 54% (n = 346) and were strongly associated with a detectable viral load and fewer CD4 cells. Errors were independently associated with nonwhite race and with depressive symptoms, poorer self-efficacy for safer drug use, and worse attitudes toward HIV medications. CONCLUSIONS: Modifiable factors associated with poor adherence, including depressive symptoms and poor self-efficacy, should be targeted for intervention. Because medication errors are prevalent and associated with a detectable viral load and fewer CD4 cells, interventions should include particular efforts to identify medication taking inconsistent with antiretroviral prescriptions.

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
Volume46
Issue numberSUPPL. 2
DOIs
StatePublished - Nov 2007

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Medication Errors
Self Efficacy
Drug Users
Viral Load
HIV
Depression
Injections
Prescriptions
Pharmaceutical Preparations
Therapeutics
Equipment and Supplies
Research

Keywords

  • Adherence
  • Antiretrovirals
  • HIV
  • Injection drug use
  • Medication errors

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users. / Arnsten, Julia H.; Li, Xuan; Mizuno, Yuko; Knowlton, Amy Ruth; Gourevitch, Marc N.; Handley, Kathleen; Knight, Kelly R.; Metsch, Lisa R.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 46, No. SUPPL. 2, 11.2007.

Research output: Contribution to journalArticle

Arnsten, Julia H. ; Li, Xuan ; Mizuno, Yuko ; Knowlton, Amy Ruth ; Gourevitch, Marc N. ; Handley, Kathleen ; Knight, Kelly R. ; Metsch, Lisa R. / Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users. In: Journal of Acquired Immune Deficiency Syndromes. 2007 ; Vol. 46, No. SUPPL. 2.
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