Document Detail


Methamphetamine use and neuropsychiatric factors are associated with antiretroviral non-adherence.
MedLine Citation:
PMID:  22530794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The present study assesses the impact of methamphetamine (METH) on antiretroviral therapy (ART) adherence among HIV+ persons, as well as examines the contribution of neurocognitive impairment and other neuropsychiatric factors [i.e., major depressive disorder (MDD), antisocial personality disorder (ASPD), and attention deficit disorder (ADHD)] for ART non-adherence. We examined HIV+ persons with DSM-IV-diagnosed lifetime history of METH abuse/dependence (HIV+ /METH+ ; n=67) as compared to HIV+ participants with no history of METH abuse/dependence (HIV+ /METH - ; n=50). Ancillary analyses compared these groups with a small group of HIV+ /METH+ persons with current METH abuse/dependence (HIV+ /CU METH+ ; n=8). Non-adherence was defined as self-report of any skipped ART dose in the last four days. Neurocognitive functioning was assessed with a comprehensive battery, covering seven neuropsychological domains. Lifetime METH diagnosis was associated with higher rates of detectable levels of plasma and CSF HIV RNA. When combing groups (i.e., METH+ and METH- participants), univariate analyses indicated co-occurring ADHD, ASPD, and MDD predicted ART non-adherence (p's < 0.10; not lifetime METH status or neurocognitive impairment). A significant multivariable model including these variables indicated that only MDD uniquely predicted ART non-adherence after controlling for the other variables (p<0.05). Ancillary analyses indicated that current METH users (use within 30 days) were significantly less adherent (50% prevalence of non-adherence) than lifetime METH+ users and HIV+ /METH- participants and that neurocognitive impairment was associated with non-adherence (p's < 0.05). METH use disorders are associated with worse HIV disease outcomes and ART medication non-adherence. Interventions often target substance use behaviors alone to enhance antiretroviral treatment outcomes; however, in addition to targeting substance use behaviors, interventions to improve ART adherence may also need to address coexisting neuropsychiatric factors and cognitive impairment to improve ART medication taking.
Authors:
David J Moore; Kaitlin Blackstone; Steven Paul Woods; Ronald J Ellis; J Hampton Atkinson; Robert K Heaton; Igor Grant;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-04-24
Journal Detail:
Title:  AIDS care     Volume:  24     ISSN:  1360-0451     ISO Abbreviation:  AIDS Care     Publication Date:  2012  
Date Detail:
Created Date:  2012-10-30     Completed Date:  2013-01-24     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  8915313     Medline TA:  AIDS Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  1504-13     Citation Subset:  IM; X    
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, CA, USA. djmoore@ucsd.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Amphetamine-Related Disorders / complications,  psychology*
Antiretroviral Therapy, Highly Active / psychology*
Central Nervous System Stimulants / administration & dosage*
Cognition Disorders / complications,  psychology*
Diagnosis, Dual (Psychiatry)
Female
HIV Infections / complications,  drug therapy,  psychology*
Humans
Logistic Models
Male
Medication Adherence / psychology*,  statistics & numerical data
Methamphetamine / administration & dosage*
Middle Aged
Neuropsychological Tests
Grant Support
ID/Acronym/Agency:
MH 62512/MH/NIMH NIH HHS; P01DA012065/DA/NIDA NIH HHS; P30MH62512/MH/NIMH NIH HHS; P50 DA026306/DA/NIDA NIH HHS; P50DA026306/DA/NIDA NIH HHS; T32 DA031098/DA/NIDA NIH HHS; T32DA31098/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Central Nervous System Stimulants; 537-46-2/Methamphetamine
Investigator
Investigator/Affiliation:
Igor Grant / ; J Hampton Atkinson / ; Ronald J Ellis / ; J Allen McCutchan / ; Thomas D Marcotte / ; Jennifer Marquie-Beck / ; Melanie Sherman / ; Ronald J Ellis / ; J Allen McCutchan / ; Scott Letendre / ; Edmund Capparelli / ; Rachel Schrier / ; Terry Alexander / ; Debra Rosario / ; Shannon LeBlanc / ; Robert K Heaton / ; Steven Paul Woods / ; Mariana Cherner / ; David J Moore / ; Matthew Dawson / ; Terry Jernigan / ; Christine Fennema-Notestine / ; Sarah L Archibald / ; John Hesselink / ; Jacopo Annese / ; Michael J Taylor / ; Eliezer Masliah / ; Cristian Achim / ; Ian Everall / ; Douglas Richman / ; David M Smith / ; J Allen McCutchan / ; Cristian Achim / ; Stuart Lipton / ; J Hampton Atkinson / ; Rodney von Jaeger / ; Anthony C Gamst / ; Clint Cushman / ; Ian Abramson / ; Florin Vaida / ; Reena Deutsch / ; Anya Umlauf / ; Tanya Wolfson / ; Igor Grant / ; Ronald J Ellis / ; Cristian Achim / ; Scott Letendre / ; Steven Paul Woods / ; Aaron Carr / ; Scott Letendre / ; Ronald J Ellis / ; Rachel Schrier / ; Robert K Heaton / ; J Hampton Atkinson / ; Mariana Cherner / ; Thomas Marcotte / ; Gregory Brown / ; Terry Jernigan / ; Anders Dale / ; Thomas Liu / ; Miriam Scadeng / ; Christine Fennema-Notestine / ; Sarah L Archibald / ; Cristian Achim / ; Eliezer Masliah / ; Ian Everall / ; Stuart Lipton / ; J Hampton Atkinson / ; Rodney von Jaeger / ; Anthony C Gamst / ; Clint Cushman / ; Ian Abramson / ; Florin Vaida / ; Reena Deutsch / ; Anya Umlauf / ; Arpi Minassian / ; William Perry / ; Mark Geyer / ; Amanda B Grethe / ; Martin Paulus / ; Ronald J Ellis / ; Sheldon Morris / ; David M Smith / ; Igor Grant / ; Svetlana Semenova / ; Athina Markou / ; Marcus Kaul /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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