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Title: Adherence to antiretroviral therapy among HIV-infected drug users: a meta-analysis
Authors: Malta, Monica Siqueira
Magnanini, Monica Maria Ferreira
Steffanie A. Strathdee
Bastos, Francisco Inácio Pinkusfeld Monteiro
Affilliation: Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento Ciência Social. Rio de Janeiro, RJ, Brasil
Universidade Federal do Rio de Janeiro. Instituto de Estudos de Saúde Coletiva. Rio de Janeiro, RJ, Brasil
University of California. School of Medicine, San Diego. Division of International Health and Cross Cultural Medicine. Department of Family and Preventive Medicine. San Diego, CA, USA.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Laboratório de Informação em Saúde. Rio de Janeiro, RJ, Brasil
Abstract: Abstract We conducted a meta-analysis of studies assessing adherence to highly active antiretroviral therapy (HAART) and a qualitative systematic review of factors associated with better HAART outcomes among HIV? drug users (DU). Thirty-eight studies were considered, which analyzed 14,960 patients (11,394 HIV? DU, 76.2%). Overall adherence (pooled percent of DU classified as adherent in each study) was 0.60 (95% CI: 0.52– 0.68), similar to levels identified by studies conducted with HIV? patients who are not drug users. Time frame used to measure adherence was an independent predictor of interstudy heterogeneity. The systematic review identified better HAART outcomes among former DU, those with less severe psychiatric conditions, those receiving opioid substitution therapy and/or psychosocial support. Patients initiating HAART with lower viral load and higher CD4 counts, and those without co-infections also had better treatment outcomes. Our findings suggest that HIV? DU tend to be inappropriately assumed to be less adherent and unlikely to achieve desirable treatment outcomes, when compared to their non-DU cohort.
Keywords: HIV
Drug use
Issue Date: 2010
Publisher: Elsevier
Citation: MALTA, Monica Siqueira et. al. Adherence to antiretroviral therapy among HIV-infected drug users: a meta-analysisAIDS and Behavior, v.14, p.731–747, 2010.
DOI: 10.1007/s10461-008-9489-7
ISSN: 1573-3254
Copyright: open access
Appears in Collections:ICICT - Artigos de Periódicos

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