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

Barbara J. Turner, John A. Fleishman, Neil Wenger, Andrew S. London, M. Audrey Burnam, Martin F. Shapiro, Eric G. Bing, Michael D. Stein, Douglas Longshore, Samuel A. Bozzette

Research output: Contribution to journalArticle

135 Scopus citations

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.

Original languageEnglish (US)
Article number1609625
Pages (from-to)625-633
Number of pages9
JournalJournal of General Internal Medicine
Volume16
Issue number9
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Keywords

  • Anti-HIV agents
  • HIV infections
  • Mental disorders
  • Substance abuse, intravenous drug abuse
  • Substance-related disorders

ASJC Scopus subject areas

  • Internal Medicine

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    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. (2001). Effects of drug abuse and mental disorders on use and type of antiretroviral therapy in HIV-infected persons. Journal of General Internal Medicine, 16(9), 625-633. [1609625]. https://doi.org/10.1046/j.1525-1497.2001.016009625.x