SUBSTANCE USE AND DEPRESSION AMONG PATIENTS ADHERENT AND NON-ADHERENT TO ANTIRETROVIRAL THERAPY

Andrey S Ustinov; Anna Pecoraro; Matthew Mimiaga; Conall O’Cleirigh; Steven Safren; Elena A Blokhina; Elena V Verbitskaya; Tatyana S Yaroslavtseva; Dmitriy A Lioznov; Alena V Suvorova; Alexandr Ya Grinenko; Edwin Eduardovich Zvartau; Evgeny M Krupitsky; George E Woody

doi:10.17816/nb13976

Neurology Bulletin ›› 2016, Vol. XLVIII ›› Issue (2) :5 -11. DOI: 10.17816/nb13976

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SUBSTANCE USE AND DEPRESSION AMONG PATIENTS ADHERENT AND NON-ADHERENT TO ANTIRETROVIRAL THERAPY

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Bekhterev Research Psychoneurological Institute

1) University of Pennsylvania

2) NIDA Clinical Trials Network, Delaware Valley Node

1)Harvard School of Public Health

2) Harvard Medical School

1) Harvard Medical School

2) Massachusetts General Hospital

First Pavlov State Medical University

1) First Pavlov State Medical University

2) Pasteur St. Petersburg Scientific Research Institute of Epidemiology and Microbiology

St. Petersburg Institute for Informatics and Automation of the Russian Academy of Sciences (SPIIRAS)

1) Bekhterev Research Psychoneurological Institute

2) First Pavlov State Medical University

2) NIDA Clinical Trials Network, Delaware Valley Node

1) School of Medicine

Valdman Institute of Pharmacology

2) Valdman Institute of Pharmacology

1) School of Medicine

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Abstract

The aim of the study was to determine the main predictors of leaving antiretroviral therapy by HIV-infected patients. We retrospectively assessed depression, hopelessness, substance use, viral load, and CD4+ counts of 120 patients who dropped out of antiretroviral therapy for ≥12 months (Lost-to-Care) and 120 who continued for ≥12 months (Engaged-in-Care). As expected, lost-to-care patients had higher viral load and, accordingly, fewer CD4+ lymphocytes. The level of depression, alcohol consumption, and injecting drug use in the 30 days preceding analysis was significantly higher in Lost-to-Care than in Engaged-in-Care HIV-infected patients. A binary logistic regression [χ2(4) = 64.27, p = 0.000] correctly classified 74.5% of participants as Lost-to-Care or Engaged-in-Care. The results indicate that substance use and depression are associated with antiretroviral therapy dropout. Evaluation of these factors with high degree of accuracy can predict patient’s antiretroviral therapy adherence. An integrated treatment for substance use and psychiatric disorders in HIV infected patients could reduce antiretroviral therapy dropout and improve outcomes of HIV treatment in Russia.

Keywords

HIV / AIDS / ART adherence / Depression / Substance use

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Andrey S Ustinov, Anna Pecoraro, Matthew Mimiaga, Conall O’Cleirigh, Steven Safren, Elena A Blokhina, Elena V Verbitskaya, Tatyana S Yaroslavtseva, Dmitriy A Lioznov, Alena V Suvorova, Alexandr Ya Grinenko, Edwin Eduardovich Zvartau, Evgeny M Krupitsky, George E Woody. SUBSTANCE USE AND DEPRESSION AMONG PATIENTS ADHERENT AND NON-ADHERENT TO ANTIRETROVIRAL THERAPY. Neurology Bulletin, 2016, XLVIII(2): 5-11 DOI:10.17816/nb13976

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Ustinov A.S., Pecoraro A., Mimiaga M., O’Cleirigh C., Safren S., Blokhina E.A., Verbitskaya E.V., Yaroslavtseva T.S., Lioznov D.A., Suvorova A.V., Grinenko A.Y., Zvartau E.E., Krupitsky E.M., Woody G.E.