Interactive effects of neurocognitive impairment and substance use on antiretroviral non-adherence in HIV disease

Arch Clin Neuropsychol. 2015 Mar;30(2):114-21. doi: 10.1093/arclin/acu092. Epub 2015 Jan 14.

Abstract

While numerous studies have established the adverse independent effects of clinical conditions including neurocognitive dysfunction, psychiatric illness, and substance abuse/dependence on medication adherence among HIV-infected adults, fewer have studied their interactive effects. The current study examined this issue among 204 HIV-infected participants based upon current neurocognitive functioning and DSM-IV-diagnosed psychiatric illness and current substance abuse or dependence. Results confirmed that participants with any of these risk factors demonstrated poorer adherence than individuals with no risk factors. A neurocognitive status × substance abuse/dependence interaction was also identified such that participants with impaired neurocognition and a co-occurring substance abuse/dependence diagnosis demonstrated the poorest adherence. Results confirm the deleterious impact of these risk factors in isolation and also identify a specific interactive effect for individuals with comorbid neurocognitive impairment and a substance abuse/dependence disorder. Findings highlight the need for interventions that simultaneously address these problems.

Keywords: Drug and alcohol abuse; HIV/AIDS.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active / methods*
  • Antiretroviral Therapy, Highly Active / psychology*
  • Assessment of Medication Adherence
  • Cognition Disorders / complications
  • Cognition Disorders / psychology*
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy
  • HIV Infections / psychology*
  • Humans
  • Male
  • Medication Adherence / psychology
  • Middle Aged
  • Neuropsychological Tests
  • Psychiatric Status Rating Scales
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / psychology*