Susan E. Cohn|Hongyu Jiang|J. Allen McCutchan|Susan L. Koletar|Robert L. Murphy|Kevin Robertson|Annabelle M. de St. Maurice|Judith S. Currier|Paige L. Williams
Association of ongoing drug and alcohol use with non-adherence to antiretroviral therapy and higher risk of AIDS and death: results from ACTG 362
University of Rochester Medical Center|Northwestern University|Harvard University|University of California, San Diego|The Ohio State University|Northwestern University|University of North Carolina at Chapel Hill|University of Pittsburgh|UCLA Medical Center|Harvard University
drug alcohol use associated worse prognosis shortterm crosssectional analyses hivinfected populations longitudinal effects adherence antiretroviral therapy art clinical outcomes advanced aids less well characterized assessed selfreported drug alcohol use aids patients examined association nonadherence death disease progression multicenter observational study defined nonadherence reporting missed art doses 48 hours study visits association drug use art nonadherence evaluated using repeated measures generalized estimating equation gee models association drug alcohol use time new aids diagnosis death evaluated via cox regression models controlling covariates including art adherence 643 participants enrolled 1997 1999 followed 2007 entry 39 reported ever using cocaine 24 amphetamines 10 heroin ongoing drug use study followup reported 9 using cocaine 4 amphetamines 1 heroin hard drug cocaine amphetamines heroin users 21 times higher odds p0001 art nonadherence gee models 25 times higher risk p004 aids progression death cox models use hard drugs attenuated risk factor aids progression death controlling nonadherence followup hr 211 p008 still suggestive possible adherenceindependent mechanism harm study highlights need continuously screen treat patients drug use part ongoing hiv care