Skip to Main content Skip to Navigation
Journal articles

Adherence to HIV treatment among IDUs and the role of opioid substitution treatment (OST).

Abstract : In the era of highly effective anti-retroviral therapy (ART), data show a significant difference in treatment outcomes between injecting drug users (IDUs) and non-IDUs. Factors that may contribute to suboptimal treatment outcomes in IDUs include delayed access to ART, competing comorbid diseases, psychosocial barriers and poor long-term adherence to ART. This review describes and compares several studies on adherence to ART and its correlates in HIV-infected individuals in general, then IDUs and finally those IDUs on opioid substitution treatment (OST). It highlights how ongoing drug use or OST can modify the pattern of these correlates. The aim is to extend all the experience acquired from these studies in order to optimise both access to care and adherence in those countries where HIV infection is mainly driven by IDUs and where ART and OST are only starting to be scaled up. The role of OST in fostering access to care and adherence to ART together with the promising results achieved to date using modified directly observed therapy (DOT) programs for patients taking methadone, allow us to emphasize the efficacy of a comprehensive care model which integrates substance dependence treatment, psychiatric treatment, social services, and medical treatment. The review concludes by suggesting areas of future research targeted at improving the understanding of both the role of perceived toxicity and patient-provider relationship for patients on ART and OST.
Document type :
Journal articles
Complete list of metadatas

Cited literature [98 references]  Display  Hide  Download

https://www.hal.inserm.fr/inserm-00167847
Contributor : Bruno Spire <>
Submitted on : Thursday, August 23, 2007 - 2:12:16 PM
Last modification on : Tuesday, September 11, 2018 - 3:08:05 PM
Long-term archiving on: : Friday, November 25, 2016 - 5:13:05 PM

File

 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : jamais

Please log in to resquest access to the document

Identifiers

Collections

Citation

Bruno Spire, Gregory Lucas, Maria Patrizia Carrieri. Adherence to HIV treatment among IDUs and the role of opioid substitution treatment (OST).. International Journal of Drug Policy, Elsevier, 2007, 18 (4), pp.262-70. ⟨10.1016/j.drugpo.2006.12.014⟩. ⟨inserm-00167847⟩

Share

Metrics

Record views

163