Archive for June 18, 2011

Dose-response Effect of Incarceration Events on Nonadherence to HIV Antiretroviral Therapy Among Injection Drug Users

Journal of Infectious Diseases  May 1, 2011 V.203 N.9 P.1215-1221

M. J. Milloy1,2, Thomas Kerr1,3, Jane Buxton2,4, Tim Rhodes5, Silvia Guillemi1, Robert Hogg1, Julio Montaner1,3 and Evan Wood1,3

1British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital

2School of Population and Public Health

3Department of Medicine, University of British Columbia

4British Columbia Centre for Disease Control, Vancouver, Canada

5London School of Hygiene and Tropical Medicine, University of London, United Kingdom

Background

Although some studies have identified impressive clinical gains for incarcerated HIV-seropositive injection drug users (IDUs) undergoing antiretroviral therapy (ART), the effect of incarceration on adherence to ART remains undetermined.

Methods

We used data from a long-term community-recruited cohort of HIV-seropositive IDUs, including comprehensive ART dispensation records, in a setting where HIV care is free. We estimated the relationship between the cumulative burden of incarceration, measured longitudinally, and the odds of <95% adherence to ART, with use of multivariate modeling.

Results

From 1996 through 2008, 490 IDUs were recruited and contributed 2220 person-years of follow-up; 271 participants (55.3%) experienced an incarceration episode, with the number of incarcerations totaling1156. Ina multivariate model, incarceration had a strong dose-dependent effect on the likelihood of nonadherence to ART: 1-2 incarceration events (adjusted odds ratio [AOR], 1.49; 95% confidence interval [95% CI], 1.03–2.05), 3–5 events (AOR, 2.48; 95% CI, 1.62–3.65), and > 5 events (AOR, 3.11; 95% CI, 1.86–4.95).

Conclusions

Among HIV-seropositive IDUs receiving ART, an increasing burden of incarceration was associated with poorer adherence in a dose-dependent fashion. Our findings support improved adherence support for HIV-seropositive IDUs experiencing incarceration.

FULL TEXT

http://jid.oxfordjournals.org/content/203/9/1215.long

PDF

http://jid.oxfordjournals.org/content/203/9/1215.full.pdf+html

June 18, 2011 at 1:11 pm Leave a comment


Calendar

June 2011
M T W T F S S
 12345
6789101112
13141516171819
20212223242526
27282930  

Posts by Month

Posts by Category