Depression, substance use, viral load, and CD4+ count among patients who continued or left antiretroviral therapy for HIV in St. Petersburg, Russian Federation

Anna Pecoraro, Matthew Mimiaga, Conall O'Cleirigh, Steven A. Safren, Elena Blokhina, Elena Verbitskaya, Tatiana Yaroslavtseva, Andrey Ustinov, Dmitry A. Lioznov, Edwin Zvartau, Evgeny Krupitsky, George E. Woody

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Antiretroviral therapy (ART) became more widely available in the Russian Federation in 2006 when the Global Fund made a contribution to purchase ART with a mandate to increase numbers of patients receiving it. Funds were distributed to AIDS Centers and selected hospitals, and numbers quickly increased. Though ART is highly effective for adherent patients, dropout has been a problem; thus understanding characteristics of patients who remain on ART vs. those who leave treatment may provide information to facilitate engagement. We retrospectively assessed depression, hopelessness, substance use, viral load, and CD4+ counts of 120 patients who dropped out of ART for ≥12 months (Lost-to-Care, LTCs) and 120 who continued for ≥12 months (Engaged-in-Care, EICs). As expected, LTCs had higher viral loads and depression, lower CD4+ counts, more alcohol, heroin, and injection drug use in the past 30 days. A binary logistic regression with Center for Epidemiologic Studies Depression score, Beck Hopelessness score, whether drugs/alcohol had ever prevented them from taking ART, and past 30 days' alcohol use [χ2(4) = 64.27, p = .0.000] correctly classified 74.5% of participants as LTC or EIC, suggesting that integrated treatment for substance use, psychiatric, and HIV could reduce dropout and improve outcomes.

Original languageEnglish (US)
Pages (from-to)86-92
Number of pages7
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume27
Issue number1
DOIs
StatePublished - Jan 15 2015
Externally publishedYes

Keywords

  • AIDS
  • Attrition
  • HIV
  • Retention
  • Russian Federation

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

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    Pecoraro, A., Mimiaga, M., O'Cleirigh, C., Safren, S. A., Blokhina, E., Verbitskaya, E., Yaroslavtseva, T., Ustinov, A., Lioznov, D. A., Zvartau, E., Krupitsky, E., & Woody, G. E. (2015). Depression, substance use, viral load, and CD4+ count among patients who continued or left antiretroviral therapy for HIV in St. Petersburg, Russian Federation. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 27(1), 86-92. https://doi.org/10.1080/09540121.2014.959464