Date of Award

2001

Degree Type

Thesis

Degree Name

Master of Science in Pharmacy Administration

Department

Pharmacy Practice

First Advisor

Cynthia Willey

Abstract

The study of adherence to antiretroviral therapy among HIV positive Injection Drug Users (IDUs) has been largely neglected. Many clinicians believe that this group is too unreliable to take these medications, particularly in the early stage of their recovery from drug abuse when they are vulnerable to relapse. This is the first study of its kind to compare medication adherence rates between HIV positive injection drug users and non-users.

The medication adherence among IDUs and non-IDUs was compared in an HIV infected population (n=143) who were currently on antiretroviral therapy. The factors affecting medication adherence were also examined in the same population. Data on demographics, clinical characteristics, mood status, physical functioning and social support was obtained. Medication adherence was measured using the "Temptation to skip antiretroviral medication scale" and "Percent of doses missed in the past week, month and three months".

Multiple T-tests conducted on the data revealed that IDUs and non-IDUs had no distinction in medication adherence behavior (p<0.05). Therefore, further group difference analyses such as multiple T-tests and Chi-Square tests were done on all other independent variables to look for possible cofounders.

These bivariate analyses showed that IDUs were older, sicker, less educated and had a longer duration of HIV positive status than non-IDUs. IDUs were also found to have worse mental health, more severity of bodily pain and more interference of pain with normal work that non-IDUs.

Multiple ANCOVAs conducted to control for these possibly confounding factors, however showed no significant differences in medication adherence between IDUs and non-IDUs. These results suggested that age, severity of disease, educational level, duration of seropositive status, general mental health, severity of bodily pain and pain interfering with normal work did not affect medication adherence in HIV positive IDUs and non-IDUs.

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