Binge Drinking Is Associated with Differences in Weekday & Weekend Adherence in HIV-Infected Individuals
BACKGROUND:
Understanding
patterns of antiretroviral adherence and its predictors is important for
designing tailored interventions. Alcohol use is associated with non-adherence.
This study aimed to evaluate: (1) if there was a difference in weekday compared
with weekend adherence in HIV-infected individuals from low and middle income
countries (LMIC), and (2) whether binge drinking was associated with this
difference.
METHODS:
Data from
a randomized trial conducted at 9 sites in 8 LMIC were analyzed.
Microelectronic monitors were used to measure adherence. Differences between
weekday and weekend adherence in each quarter (successive 12-week periods) were
compared using Wilcoxon signed rank tests and predictors of adherence,
including baseline binge drinking, were evaluated using Generalized Estimating
Equations.
RESULTS:
Data from
255 participants were analyzed: 49.8% were male, median age was 37 years and
28.6% enrolled in Haiti. At study entry, only 2.7% reported illicit substance
use, but 22.3% reported binge drinking at least once in the 30 days prior to
enrollment. Adherence was higher on weekdays than weekends (median percent
doses taken: 96.0% vs 94.4%; 93.7% vs 91.7%; 92.6% vs 89.7% and 93.7% vs 89.7%
in quarters 1-4 respectively, all p<0.001). Binge drinking at baseline and
time on study were both associated with greater differences between weekday and
weekend adherence.
CONCLUSIONS:
Adherence
was worse on weekends compared to weekdays: difference was small at treatment
initiation, increased over time and was associated with binge drinking.
Screening and new interventions to address binge drinking, a potentially
modifiable behavior, may improve adherence in HIV-infected individuals in LMIC.
By: De Boni RB1, Zheng L2, Rosenkranz SL2, Sun X2, Lavenberg J2, Cardoso SW3, Grinsztejn B3, La Rosa A4, Pierre S5, Severe P5, Cohn SE6, Collier AC7, Gross R8.
- 1Center for Biostatistics in AIDS Research (CBAR), Harvard School of Public Health, Boston, MA, USA; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil. Electronic address: raqueldeboni@gmail.com.
- 2Center for Biostatistics in AIDS Research (CBAR), Harvard School of Public Health, Boston, MA, USA.
- 3Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
- 4Asociacion Civil Impacta Salud y Educacion, Lima, Peru.
- 5Institut National de Laboratoire et de Recherches, Centres Gheskio, Port au Prince, Haiti.
- 6Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- 7Harborview Medical Center, University of Washington, Seattle, WA, USA.
- 8Department of Medicine (Infectious Diseases) and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- Drug Alcohol Depend. 2016 Feb 1;159:174-80. doi: 10.1016/j.drugalcdep.2015.12.013. Epub 2015 Dec 24.
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