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Determinants of HAART discontinuation among injection drug users

T Kerr1, A Marshall, J Walsh

  • 1Canadian HIV/AIDS Legal Network, St. Paul's Hospital, British Columbia, Canada. tkerr@aidslaw.ca

AIDS Care
|July 23, 2005
PubMed

Insights

Highly active antiretroviral therapy (HAART) discontinuation in HIV-positive injection drug users is linked to incarceration and negative expectations. Interventions should address self-efficacy and incarceration barriers for better treatment adherence.

Area of Science:

  • Public Health
  • Behavioral Science
  • Infectious Disease

Background:

  • Highly active antiretroviral therapy (HAART) is crucial for managing HIV/AIDS.
  • Injection drug users (IDUs) face unique challenges in adhering to long-term treatment regimens.
  • Understanding factors influencing HAART discontinuation is vital for improving patient outcomes.

Purpose of the Study:

  • To identify psychosocial determinants of HAART discontinuation among HIV-positive IDUs.
  • To explore self-reported reasons for HAART cessation in this population.
  • To inform targeted interventions for enhancing HAART adherence.

Main Methods:

  • Cross-sectional study involving 160 HIV-positive participants from the Vancouver Injection Drug Users' Study (VIDUS).
  • Logistic regression analysis to identify factors independently associated with HAART discontinuation.
  • Assessment of sociodemographic characteristics, drug use, risk behaviors, outcome expectations, and self-efficacy.

Main Results:

  • 44% of participants discontinued HAART during the study period.
  • Incarceration (OR=4.84), negative outcome expectations (OR=1.41), and lower adherence self-efficacy (OR=0.70) were significantly associated with discontinuation.
  • Primary reasons for discontinuation included incarceration (44%) and medication side effects (41%).

Conclusions:

  • Psychological factors, particularly self-efficacy, play a significant role in HAART discontinuation among HIV-positive IDUs.
  • Incarceration presents a major barrier to sustained HAART use, necessitating programmatic adjustments.
  • Interventions should focus on improving self-efficacy and addressing structural barriers like incarceration to improve HAART retention.

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