DSM-5 substance use disorder symptom clusters and HIV antiretroviral therapy (ART) adherence

ABSTRACT

This study examines self-reported 30-day antiretroviral therapy (ART) adherence among 101 people living with HIV and substance use disorders (SUD) in New York City in terms of Diagnostic and Statistical Manual – 5th Edition (DSM-5) SUD symptom clusters: impaired control, social impairment, risky use and pharmacological criteria. Overall, 60.4% met DSM-5 criteria for stimulant, 55.5% for alcohol, 34.7% for cannabis and 25.7% for opioid SUD. Of the 76 participants with a current ART prescription, 75.3% reported at least 90% 30-day adherence. Participants with vs. without alcohol SUD were significantly less likely to report ART adherence (64.3% vs. 88.2%, p = .017). Endorsement of social impairment significantly differed among adherent vs. non-adherent participants with alcohol SUDs (74.1% vs. 100%, p = .038) and with opioid SUDs (94.1% vs. 50.0%, p = .040). Understanding specific SUD symptom clusters may assist providers and patients in developing strategies to improve ART adherence.

KEYWORDS:

• Antiretroviral therapy
• HIV/AIDS
• substance use disorders
• medication adherence
• DSM-5

Acknowledgements

The authors would like to acknowledge our research assistants (Laurel Weaver, Jeannie Ortiz and Martha Nelson) and our study participants.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institutes of Health, National Institute on Drug Abuse under grant R01 DA035707 (Multiple PIs: Don Des Jarlais, Ph.D. and Aimee Campbell, Ph.D.) and R01 DA003574 (PI: Des Jarlais). Dr. Margaret Paschen-Wolff was supported by the National Institute of Mental Health at the HIV Center for Clinical and Behavioral Studies at the NY State Psychiatric Institute and Columbia University under a training grant T32 MH019139 (PI: Theodorus Sandfort) and P30 MH43520 (Center Principal Investigator: Robert Remien, Ph.D.).