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Drug Alcohol Depend. 2016 Feb 1;159:174-80. doi: 10.1016/j.drugalcdep.2015.12.013. Epub 2015 Dec 24.

Binge drinking is associated with differences in weekday and weekend adherence in HIV-infected individuals.

Author information

1
Center for Biostatistics in AIDS Research (CBAR), Harvard School of Public Health, Boston, MA, USA; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil. Electronic address: raqueldeboni@gmail.com.
2
Center for Biostatistics in AIDS Research (CBAR), Harvard School of Public Health, Boston, MA, USA.
3
Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
4
Asociacion Civil Impacta Salud y Educacion, Lima, Peru.
5
Institut National de Laboratoire et de Recherches, Centres Gheskio, Port au Prince, Haiti.
6
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
7
Harborview Medical Center, University of Washington, Seattle, WA, USA.
8
Department of Medicine (Infectious Diseases) and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

Abstract

BACKGROUND:

Understanding patterns of antiretroviral adherence and its predictors is important for designing tailored interventions. Alcohol use is associated with non-adherence. This study aimed to evaluate: (1) if there was a difference in weekday compared with weekend adherence in HIV-infected individuals from low and middle income countries (LMIC), and (2) whether binge drinking was associated with this difference.

METHODS:

Data from a randomized trial conducted at 9 sites in 8 LMIC were analyzed. Microelectronic monitors were used to measure adherence. Differences between weekday and weekend adherence in each quarter (successive 12-week periods) were compared using Wilcoxon signed rank tests and predictors of adherence, including baseline binge drinking, were evaluated using Generalized Estimating Equations.

RESULTS:

Data from 255 participants were analyzed: 49.8% were male, median age was 37 years and 28.6% enrolled in Haiti. At study entry, only 2.7% reported illicit substance use, but 22.3% reported binge drinking at least once in the 30 days prior to enrollment. Adherence was higher on weekdays than weekends (median percent doses taken: 96.0% vs 94.4%; 93.7% vs 91.7%; 92.6% vs 89.7% and 93.7% vs 89.7% in quarters 1-4 respectively, all p<0.001). Binge drinking at baseline and time on study were both associated with greater differences between weekday and weekend adherence.

CONCLUSIONS:

Adherence was worse on weekends compared to weekdays: difference was small at treatment initiation, increased over time and was associated with binge drinking. Screening and new interventions to address binge drinking, a potentially modifiable behavior, may improve adherence in HIV-infected individuals in LMIC.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00608569.

KEYWORDS:

Adherence; Alcohol; Binge drinking; HIV/AIDS; Low and middle income countries; Microelectronic monitors

PMID:
26774947
PMCID:
PMC4860880
DOI:
10.1016/j.drugalcdep.2015.12.013
[Indexed for MEDLINE]
Free PMC Article

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