Adherence to Antiretroviral Therapy Among HIV-Infected Drug Users: A Meta-Analysis

被引：170

作者：

Malta, Monica ^{[1
]}

Magnanini, Monica M. F. ^{[2
]}

Strathdee, Steffanie A. ^{[3
]}

Bastos, Francisco I. ^{[4
]}

机构：

[1] Fundacao Oswaldo Cruz, Dept Social Sci, Sergio Arouca Sch Publ Hlth DCS ENSP, BR-21041210 Rio De Janeiro, Brazil

[2] Fed Univ Rio de Janeiro IESC UFRJ, Inst Publ Hlth Studies, Rio De Janeiro, Brazil

[3] Univ Calif San Diego, Div Int Hlth & Cross Cultural Med, Dept Family & Prevent Med, Sch Med, San Diego, CA 92103 USA

[4] Fundacao Oswaldo Cruz, Hlth Informat Lab, Ctr Sci & Technol Informat LIS ICICT, BR-21041210 Rio De Janeiro, Brazil

来源：

AIDS AND BEHAVIOR | 2010年 / 14卷 / 04期

关键词：

HIV; AIDS; Adherence; Drug use; Meta-analysis; CELL COUNT RESPONSES; MEDICATION ADHERENCE; VIROLOGICAL RESPONSE; TREATMENT OUTCOMES; TERM ADHERENCE; SELF-REPORT; VIRAL LOAD; IMPACT; HAART; VIRUS;

D O I：

10.1007/s10461-008-9489-7

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

We conducted a meta-analysis of studies assessing adherence to highly active antiretroviral therapy (HAART) and a qualitative systematic review of factors associated with better HAART outcomes among HIV+ drug users (DU). Thirty-eight studies were considered, which analyzed 14,960 patients (11,394 HIV+ DU, 76.2%). Overall adherence (pooled percent of DU classified as adherent in each study) was 0.60 (95% CI: 0.52-0.68), similar to levels identified by studies conducted with HIV+ patients who are not drug users. Time frame used to measure adherence was an independent predictor of inter-study heterogeneity. The systematic review identified better HAART outcomes among former DU, those with less severe psychiatric conditions, those receiving opioid substitution therapy and/or psychosocial support. Patients initiating HAART with lower viral load and higher CD4 counts, and those without co-infections also had better treatment outcomes. Our findings suggest that HIV+ DU tend to be inappropriately assumed to be less adherent and unlikely to achieve desirable treatment outcomes, when compared to their non-DU cohort.

引用

页码：731 / 747

页数：17

共 98 条

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