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Monique A. Wyatt, Toni Tugenberg, MEd, LICSW, and Norma C. Ware, PhD. Department of Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115, 617-432-6019, monique_wyatt@hms.harvard.edu
Background: Illegal drug users are among a number of disadvantaged populations lacking equitable access to state-of-the-art therapies for HIV/AIDS. Assumptions about the inability of drug users to adhere to complicated medication regimens appear to be one reason for this. Methods: Data from a qualitative study were used to describe patterns of adherence to HAART in illegal drug users. Fifty-two active users prescribed HAART participated in multiple, semi-structured interviews (Total: 212) focusing on medication-taking and drug use. Active drug use was defined as one or more episodes in the three months prior to study enrollment. Results: The sample was mostly male (73%), heterosexual (60%) and either African-American (38%) or white (48%). Most were poor. Drugs of choice were crack cocaine (65%), cocaine (62%), and heroin (40%). Participants varied widely in patterns of adherence. Adherence usually declined during episodes of drug use; however, the sample contained many infrequent users who reported taking HAART as prescribed when not using. Specific instances of adherence during drug use were also reported. Numerous factors other than drug use impeded adherence, e.g., comorbid illnesses, relationship conflicts, financial concerns. Participants employed the same strategies to sustain adherence efforts as those reported by non-users in other studies. These results are inconsistent with assumptions about the adherence of drug users. Conclusion: Adherence cannot be accurately predicted for individuals simply on the basis of perceptions about drug users. Efforts to support adherence should engage users in a comprehensive discussion of drug involvement, while also addressing barriers unrelated to drug use.
Learning Objectives: At the conclusion of the presentation, the participant will be able to
Keywords: Adherence, Antiretroviral Combination Therapy
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.