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


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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.

About the authors

Andrey S Ustinov

Bekhterev Research Psychoneurological Institute

Email: andrey.ustinov29@gmail.com
192019, St. Petersburg, Bekhterev str., 3

Anna Pecoraro

1) University of Pennsylvania; 2) NIDA Clinical Trials Network, Delaware Valley Node

1) School of Medicine Philadelphia, PA, USA

Matthew Mimiaga

1)Harvard School of Public Health; 2) Harvard Medical School

Boston, MA, USA

Conall O’Cleirigh

1) Harvard Medical School; 2) Massachusetts General Hospital

Boston, MA, USA

Steven Safren

1) Harvard Medical School; 2) Massachusetts General Hospital

Boston, MA, USA

Elena A Blokhina

First Pavlov State Medical University

Valdman Institute of Pharmacology 197022, St. Petersburg, L. Tolstoi str., 6-8

Elena V Verbitskaya

First Pavlov State Medical University

Valdman Institute of Pharmacology 197022, St. Petersburg, L. Tolstoi str., 6-8

Tatyana S Yaroslavtseva

First Pavlov State Medical University

Valdman Institute of Pharmacology 197022, St. Petersburg, L. Tolstoi str., 6-8

Dmitriy A Lioznov

1) First Pavlov State Medical University; 2) Pasteur St. Petersburg Scientific Research Institute of Epidemiology and Microbiology

1) кафедра инфекционных болезней и эпидемиологии 1) 197022, St. Petersburg, L. Tolstoi str., 6-8; 2) 197101, St. Petersburg, Mira str., 14

Alena V Suvorova

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

1999178, St. Petersburg, line 14, 39

Alexandr Ya Grinenko

First Pavlov State Medical University

Valdman Institute of Pharmacology 197022, St. Petersburg, L. Tolstoi str., 6-8

Edwin Eduardovich Zvartau

First Pavlov State Medical University

Valdman Institute of Pharmacology 197022, St. Petersburg, L. Tolstoi str., 6-8

Evgeny M Krupitsky

1) Bekhterev Research Psychoneurological Institute; 2) First Pavlov State Medical University

2) Valdman Institute of Pharmacology 1) 192019, St. Petersburg, Bekhterev str., 3; 2) 197022, St. Petersburg, L. Tolstoi str., 6-8

George E Woody

1) University of Pennsylvania; 2) NIDA Clinical Trials Network, Delaware Valley Node

1) School of Medicine Philadelphia, PA, USA

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Copyright (c) 2016 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.

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