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Adherence to Antiretroviral Medications Among Persons Who Inject Drugs in Transitional, Low and Middle Income Countries: An International Systematic Review

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Abstract

Adherence to antiretroviral (ART) medication is vital to reducing morbidity and mortality among HIV positive persons. People who inject drugs (PWID) are at high risk for HIV infection in transitional/low/middle income countries (TLMIC). We conducted a systematic review of studies reporting adherence to ART among persons with active injection drug use and/or histories of injection drug use in TLMIC. Meta-regression was performed to examine relationships between location, adherence measurements, and follow-up period. Fifteen studies were included from seven countries. Adherence levels ranged from 33 to 97 %; mean weighted adherence was 72 %. ART adherence was associated with different methods of measuring adherence and studies conducted in Eastern Europe and East Asia. The great heterogeneity observed precludes generalization to TLMIC as a whole. Given the critical importance of ART adherence more research is needed on ART adherence among PWID in TLMIC, including the use of standardized methods for reporting adherence to ART.

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Acknowledgments

This study was funded by the National Institutes of Health (R01 AI 083035). The views expressed in this publication do not necessarily represent the position of the National Institutes of Health, Mount Sinai Beth Israel, or the University of Tartu.

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The authors disclose no financial conflicts of interest.

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Authors and Affiliations

  1. The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 160 Water Street, New York, NY, 10038, USA

    Jonathan Feelemyer, Don Des Jarlais & Kamyar Arasteh

  2. Department of Public Health, University of Tartu, Tartu, Estonia

    Anneli Uusküla

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  1. Jonathan Feelemyer
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  2. Don Des Jarlais
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  4. Anneli Uusküla
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Correspondence to Jonathan Feelemyer.

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Feelemyer, J., Des Jarlais, D., Arasteh, K. et al. Adherence to Antiretroviral Medications Among Persons Who Inject Drugs in Transitional, Low and Middle Income Countries: An International Systematic Review. AIDS Behav 19, 575–583 (2015). https://doi.org/10.1007/s10461-014-0928-3

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