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

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...

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Bibliographic Details
Published in:Archives of clinical neuropsychology 2015-03, Vol.30 (2), p.114-121
Main Authors: Thaler, Nicholas S, Sayegh, Philip, Kim, Michelle S, Castellon, Steven A, Hinkin, Charles H
Format: Article
Language:English
Subjects:
Adult
Antiretroviral Therapy, Highly Active - methods
Antiretroviral Therapy, Highly Active - psychology
Cognition Disorders - complications
Cognition Disorders - psychology
Female
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - psychology
Human immunodeficiency virus
Humans
Male
Medication Adherence - psychology
Medication Adherence - statistics & numerical data
Middle Aged
Neuropsychological Tests
Original Empirical
Psychiatric Status Rating Scales
Substance-Related Disorders - complications
Substance-Related Disorders - psychology
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Summary: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.
ISSN:0887-6177
1873-5843
DOI:10.1093/arclin/acu092