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APHA Scientific Session and Event Listing

Recorded presentation

Karolynn Siegel, PhD¹, Eric W. Schrimshaw, MA (PhD cand)¹, Helen-Maria Lekas, PhD¹, and Jason Leider, MD; PhD². (1) Center for the Psychosocial Study of Health & Illness, Columbia University, 100 Haven Avenue, Suite 6A, New York, NY 10032, 212-304-6489, es458@columbia.edu, (2) Director of Adult HIV Services, Albert Einstein College of Medicine, NBHN, Jacobi Medical Center, 1400 Pelham Parkway So., 6A-01 JACP, Bronx, NY 10461

BACKGROUND: Although the risk of nonadherence to antiretroviral medications among HIV-positive injecting drug users (IDU) has been documented, still unexamined is whether the co-infection with Hepatitis C (HCV) further impedes antiviral adherence. METHOD: Factors associated with self-reported adherence to antiviral medications were assessed among 109 HIV/HCV co-infected IDU recruited from two hospital-based HIV-clinics in Bronx, New York. The sample was 72% male, 66% Puerto Rican, and 87% reported no injection drug use in the past year. RESULTS: Nonadherence was common, with 39% reporting missing one or more doses in the past 2 weeks. Women (55% vs. 33%), those who were unmarried (48% vs. 19%), and those who lived alone (50% vs. 32%) were more likely be nonadherent. Participants who drank alcohol in the past month (regardless of frequency or quantity) were more nonadherent (54% vs. 33%). Nonadherence was also associated more depressive symptoms (r = .23), anxious symptoms (r = .22), more HIV-related physical symptoms (r = .17, p = .08), and more perceived stigma toward PLWHIV (r = .18, p = .08). Race/ethnicity, social support, attitudes toward medications, attitudes toward their physician, and recent injecting drug use were not associated with adherence. Multivariate analyses revealed that gender and alcohol use were most strongly associated with nonadherence. CONCLUSION: These findings suggest that interventions to promote adherence to antiviral medications are needed among HIV/HCV co-infected IDU. Further, they suggest that alcohol reduction efforts may indirectly promote adherence, as well as helping to reduce further liver damage.

Learning Objectives:

• Understand the past research on factors which contribute to nonadherence to antiretroviral treatments.
• Describe the reasons why HIV/HCV co-infected IDU may be a greater risk for nonadherence to antiretroviral treatments.
• Report on the factors associated with nonadherence among HIV/HCV co-infected IDU.
• Suggest ways in which these findings may be applied in interventions to promote optimal adherence among HIV/HCV co-infected IDU.

Keywords: Adherence, Hepatitis C

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation