High levels of adherence to highly active antiretroviral therapy (HAART) are associated with improved outcomes for patients with HIV. Through interviews with 659 patients with HIV, researchers in this study assessed whether illicit substance use and receiving substance use treatment influence adherence to HAART.

Forty-two percent of the patients had used illicit drugs in the past 6 months (current use), 30% had used illicit drugs but not in the past 6 months (former use), and 28% had never used illicit drugs.

• Significantly less common among subjects with current use (60%) than among subjects with former (68%) or no (77%) use
• Similar between subjects with former use who had received recent substance use treatment and subjects with no use
• Lower in subjects with former use who had not received recent substance use treatment than in subjects with no use
• Lower in subjects with current use than in subjects with no use, regardless of receipt of substance use treatment

Comments by James Harrison, MHS, CADC
This study on HAART adherence highlights the negative impact of current illicit drug use as well as the benefits of substance use treatment. Elements of substance use treatment that may improve HAART adherence include direct observation therapy (when patients report to a substance use treatment program daily) and breathalyzers to assess alcohol use at each treatment visit. Further research is needed to evaluate the efficacy of substance abuse treatment, particularly those programs that provide direct observation therapy as an intervention for adherence to HAART (see related summary).