Tuesday, January 26, 2016

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.

Purchase full article at:   http://goo.gl/ImiA29

  • 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. 
  •  2016 Feb 1;159:174-80. doi: 10.1016/j.drugalcdep.2015.12.013. Epub 2015 Dec 24.




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