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

被引:0
作者
Monica Malta
Monica M. F. Magnanini
Steffanie A. Strathdee
Francisco I. Bastos
机构
[1] Oswaldo Cruz Foundation,Social Science Department, Sergio Arouca School of Public Health (DCS/ENSP)
[2] Federal University of Rio de Janeiro (IESC/UFRJ),Institute of Public Health Studies
[3] San Diego (UCSD) School of Medicine,Division of International Health and Cross Cultural Medicine, Department of Family and Preventive Medicine at University of California
[4] Oswaldo Cruz Foundation,Health Information Laboratory, Center for Scientific and Technological Information (LIS/ICICT)
来源
AIDS and Behavior | 2010年 / 14卷
关键词
HIV; AIDS; Adherence; Drug use; Meta-analysis;
D O I
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中图分类号
学科分类号
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.
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页码:731 / 747
页数:16
相关论文
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