Past Sponsored Research Projects

Adherence to HIV Therapies in Drug Users in New Orleans

Dates of contract: 1 April 1998 to 3 March 2000
Funding source: National Institutes of Health, National Institute on Drug Abuse
Tulane's role: Tulane is the lead institution on the project. Tulane will be working in collaboration with LSU Medical Center.
Countries: USA only
Principal Investigators: Carl Kendall, PhD, Patty Kissinger, PhD

This project - currently being analyzed - is designed to explore adherence to new HIV treatment regimens among individuals with a history of substance use who are also attending the HIV Outpatient Program of the Medical Center of Louisiana (HOP) in New Orleans. Adherence to drug therapy is an important factor in increasing the effectiveness of new antiretroviral therapy.  New combination antiretroviral drug therapies promise to convert HIV into a chronic disease. Yet, the complexity of antiretroviral drug regimens, side effects, and the changing population of AIDS patients may increase the likelihood of non-adherence with these chronically used drugs. Unfortunately, even relatively modest non-adherence with some of the combination regimens, particularly those that include a protease inhibitor, may lead to viral resistance, reversed progression of HIV disease and ineffectiveness of multiple antiretroviral drugs. In addition, a comprehensive model of adherence does not exist for this or any population. The goal of this research is to explore the determinants of adherence, both in terms of sociodemographic and drug use variables, but also from the perspective of the individual’s own understanding of HIV, the action of these therapies, and their own ability to organize complaince.

The project follows a population of approximately 225 men and women who are patients in the HIV Outpatient Program. All participants must be 18 years of age or older, be a current substance user or have a history of substance abuse, be HIV anti-viral therapy na�ve, have a CD4 count of less than 500, be starting to use any combination of anti-HIV drug therapies, not be considered too ill to participate, and not be institutionalized. Each participant will be interviewed a total of 4-5 times over the 2 years of the project. A baseline quantitative survey was conducted, and 3 month, 6 month and one year follow-up surveys completed as well. This instrument incorporates NIH’s latest adherence measurement instruments and combines scales from a number of other instruments as well. In addition, a subset of the study population was asked to complete an in-depth interview qualitative interview with specially trained field workers. The interviews were conducted on site in the HOP clinic as well as at patient's homes. The study has been successful in preserving the confidentiality of all participants in this study.