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Medication Adherence and HIV Symptom Distress in Relation to Panic Disorder Among HIV-Positive Adults Managing Opioid Dependence

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Abstract

Panic disorder (PD) occurs at greater rates among those with HIV compared to those without HIV. Rates of PD may be elevated among those with opioid dependence (persons who inject drugs, PWID). Persons with HIV experience common bodily symptoms as a result of the disease and these symptoms overlap with those of PD which may contribute to a “fear of fear” cycle present in PD. HIV-positive, PWID represent an at-risk population in terms of poor medication adherence. HIV symptoms and HIV medication side-effects commonly overlap with panic symptoms and may affect HIV medication adherence. The aim of this investigation was to examine the impact of PD on HIV-related symptom distress and HIV medication adherence in HIV-positive adults (N = 131) in treatment for opioid use. Those with a diagnosis of PD evidenced greater levels of HIV symptom distress and lower levels of medication adherence than those without current PD. Results highlight the clinical importance of assessing for and treating PD among individuals with HIV that are prescribed antiretroviral therapy. Future work would benefit from examining observed associations longitudinally and identifying potential mechanisms involved.

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Acknowledgments

Funding for data collection for this Project is from R-01 DA018603 (Safren). Some of the investigator time was supported by Grant K24 MH094214 (Safren). Dr. Safren is supported by Grant K24 MH094214. Dr. Gonzalez is supported by Grants from the National Institute for Occupational Safety and Health (200-2011-42057 and 1U01OH010524-01) and the National Institute for Environmental Health Sciences (1R21ES023583-01).

Conflict of Interest

Jesse D. Kosiba, Adam Gonzalez, Conall O’Cleirigh and Steven A. Safren declare that they have no conflict of interest.

Informed Consent

All study participants provided written informed consent. Enrollment occurred between July of 2005 and October of 2008. All study procedures were approved by the Institutional Review Boards at Massachusetts General Hospital (MGH) in Boston, MA and at Rhode Island Hospital in Providence, RI.

Animal Rights

No animal studies were carried out by the authors for this article.

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Authors and Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Jesse D. Kosiba, Conall O’Cleirigh & Steven A. Safren

  2. Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY, USA

    Adam Gonzalez

  3. Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA

    Conall O’Cleirigh & Steven A. Safren

  4. The Fenway Institute, Boston, MA, USA

    Conall O’Cleirigh & Steven A. Safren

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  1. Jesse D. Kosiba
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  2. Adam Gonzalez
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  3. Conall O’Cleirigh
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  4. Steven A. Safren
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Correspondence to Steven A. Safren.

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Kosiba, J.D., Gonzalez, A., O’Cleirigh, C. et al. Medication Adherence and HIV Symptom Distress in Relation to Panic Disorder Among HIV-Positive Adults Managing Opioid Dependence. Cogn Ther Res 38, 458–464 (2014). https://doi.org/10.1007/s10608-014-9608-x

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  • DOI: https://doi.org/10.1007/s10608-014-9608-x

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