Washington, Oct 24 (Inditop.com) Strict adherence to anti-retroviral therapy (ART) ensures longevity and better quality of life for HIV patients. But then why do so many of them find it so difficult to follow the therapy?
Two new University of Washington (UW) studies illustrate just how hard it is to ensure people take their HIV medication. One study looked at the effects of drinking alcohol on adherence and showed the risk for non-adherence was double among drinkers compared to abstainers.
The second study evaluated interventions using peers, electronic pagers or both, and showed that these tools promoted no lasting improvements in adherence rates.
ART combines at least three antiretroviral (ARV) drugs to maximally suppress the HIV virus and stop its progression.
“HIV is unique in the adherence levels needed to be effective,” said Jane Simoni, UW psychology professor who specialises in studying adherence. She led the study on the pager-peer paper and co-authored the alcohol study.
“Typical adherence for people taking medication is 50 percent. But 50 or 60 percent adherence isn’t going to work for HIV medications and will lead to resistance to the drugs. Taking drugs for HIV is a lifetime commitment; you are married to the pills,” she said.
The alcohol paper analysed data from 40 previous studies involving more than 25,000 people and established that drinking does have a consistent effect on adherence across studies.
“Drinking quantity, more than frequency of drinking, is associated with non-adherence,” said Christian Hendershot, who led the alcohol study.
Hendershot is now a postdoctoral researcher at the University of New Mexico after earning his doctorate at the UW.
Because the various studies had different criteria for drinking, the researchers used meta-analysis to examine three categories – any drinking, moderate drinking and problem drinking. The latter was defined as criteria for at-risk drinking – 14 drinks a week or more than four in a day for men.
“In general, people who drank alcohol had nearly twice the risk of non-adherence. But the risk of non-adherence went up as the level of drinking went up,” he said. “At problem levels of drinking we see a higher probability of non-adherence.”
However, Hendershot cautioned that these finding don’t necessarily hold for all people on HIV medication and who drink, says an UW release.
“Alcohol may have a causal effect, but there also may be other factors affecting both alcohol and adherence that partly explain the association. We need to treat people individually.”
Both studies were published in the Journal of Acquired Immune Deficiency.
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