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Substance Use and Adherence Among People Living with HIV/AIDS Receiving cART in Latin America

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Abstract

This cross-sectional study describes substance use prevalence and its association with combination antiretroviral therapy (cART) adherence among 3343 individuals receiving care at HIV clinics in Argentina, Brazil, Chile, Honduras, Mexico, and Peru. A rapid screening tool evaluated self-reported 7-day recall of alcohol, marijuana, cocaine, heroin, and methamphetamine use, and missed cART doses. Overall, 29.3 % individuals reported having ≥1 alcoholic drinks, 5.0 % reported any illicit drug use and 17.0 % reported missed cART doses. In the logistic regression model, compared to no substance use, alcohol use [adjusted odds ratio (AOR) = 2.46, 95 % confidence interval (CI): 1.99–3.05], illicit drug use (AOR = 3.57, 95 % CI: 2.02–6.30), and using both alcohol and illicit drugs (AOR = 4.98, 95 % CI: 3.19–7.79) were associated with missed cART doses. The associations between substance use and likelihood of missing cART doses point to the need of targeting alcohol and illicit drug use to improve adherence among people living with HIV in Latin America.

Resumen

Este estudio transversal describe la prevalencia del uso de sustancias y su asociación con la adherencia a TARVc en 3433 individuos atendidos en centros clínicos de VIH en Argentina, Brasil, Chile, Honduras, México y Perú. Se aplicó una herramienta de escrutinio rápido para el uso de alcohol, marihuana, cocaína, heroína y metanfetaminas, así como para el reporte de dosis perdidas de TARV en los siete días anteriores. En general, 29.3 % participantes reportaron haber consumido una o más bebidas alcohólicas, 5% reportaron haber usado alguna droga ilícita y 17 % reportaron haber perdido al menos una dosis del TARVc. Usando un modelo de regresión logística, se observó que en comparación al grupo que no consumió ninguna sustancia, el uso de alcohol (odds ratio ajustada (AOR)=2.46, intervalo de confianza del 95 % (IC95 %): 1.99–3.05), el uso de cualquier sustancia ilícita (AOR=3.57, IC95%: 2.02–6.30), y el uso de ambos (AOR = 4.98, 95 % CI: 3.19–7.79) se asociaron a pierda de alguna dosis de TARVc. La relación entre el uso de sustancias y el incremento en la mala adherencia a la TARVc señala la necesidad de atender el uso de alcohol y drogas ilícitas para así mejorar la adherencia en personas que viven con VIH en América Latina.

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Funding

This work was supported by the National Institute of Allergy and Infectious Diseases (NIAID) as part of the International Epidemiologic Databases to Evaluate AIDS (IeDEA): U01 AI069923.

Author information

Authors and Affiliations

  1. Instituto Nacional de Infectologia Evandro Chagas - FIOCRUZ, Av. Brasil 4365, Rio de Janeiro, CEP 21040-360, Brazil

    Raquel B. De Boni & Beatriz Grinsztejn

  2. Vanderbilt University, Nashville, USA

    Bryan E. Shepherd, Peter F. Rebeiro, Stephany N. Duda & Catherine C. McGowan

  3. Fundación Huésped, Buenos Aires, Argentina

    Carina Cesar

  4. Fundación Arriaran, Santiago, Chile

    Claudia Cortés

  5. Instituto Hondureno de Seguridad Social and Hospital Escuela, Tegucigalpa, Honduras

    Eduardo Gotuzzo

  6. Universidad Peruana Cayetano Heredia, Lima, Peru

    Denis Padgett

  7. Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Pablo F. Belaunzarán-Zamudio

Authors
  1. Raquel B. De Boni
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  2. Bryan E. Shepherd
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  4. Carina Cesar
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  5. Claudia Cortés
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  6. Denis Padgett
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  7. Eduardo Gotuzzo
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  8. Pablo F. Belaunzarán-Zamudio
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  9. Peter F. Rebeiro
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  10. Stephany N. Duda
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  11. Catherine C. McGowan
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Corresponding author

Correspondence to Raquel B. De Boni.

Additional information

For the Caribbean, Central and South America network for HIV epidemiology (CCASAnet).

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De Boni, R.B., Shepherd, B.E., Grinsztejn, B. et al. Substance Use and Adherence Among People Living with HIV/AIDS Receiving cART in Latin America. AIDS Behav 20, 2692–2699 (2016). https://doi.org/10.1007/s10461-016-1398-6

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  • DOI: https://doi.org/10.1007/s10461-016-1398-6

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