COMMITMENT TO TREATMENT OF HIV-INFECTED PATIENTS WITH OPIOID DEPENDENCE

Background. Low commitment to treatment in HIV-infected patients with opioid dependence (HPODs) leads to a progression of HIV, its spread, as well as heavy medical and social consequences. The aim was to study risk factors for poor adherence to treatment in HIV-infected drug users. Material and methods. Risk factors for poor adherence to treatment among 213 HPODs were studied. The sociodemographic data of respondents, their attitude to the problem and treatment of combined pathology, the level of their awareness of the consequences of HIV infection combined with opioid dependence, the nature of social functioning, criminal activity and risk behavior as well as the organization of medical care for HPOD were analyzed. Results. The level of medication adherence was associated with the ability of HPODs to critically assess their disease state and its consequences (OR=2.5; 95% CI [1.5-4.1]; p<0.05; χ2=14.7; p<0.001; R=0.2), belief in treatment success (OR=2.5; 95% CI [1.5-4.0]; p<0.05; χ2=14.5; p<0.001; R=0.2), the nature of drug use and effectiveness of ART (OR=5.8; 95% CI [3.5-9.8]; p<0.05; χ2=49.9; p<0.001; R=0.5), problematic social functioning (OR=2.3; 95% CI [1.4-3.7]; p<0.05; χ2=11.4; p<0.001; R=0.2), criminal activity (OR=3.2; 95% CI [1.9-5.1]; p<0.05; χ2=23.4; p<0.001; R=0,1), risky behavior (OR=6.7; 95% CI [3.1-14.5]; p<0.05; χ2=28.5; p<0.001; R=0.3) and organization of medical care (OR=2.2; 95% CI [1.3-3.5]; p<0.05; χ2=9.96; p<0.002; R=0.2). Conclusions. A low level of adherence to treatment in HPODs is associated with a low ability to critically assess the painful condition and its consequences, lack of confidence in the success of treatment, active drug use and low efficiency of ART, problematic social functioning, criminal activity, risky behavior and poor quality of medical care. The knowledge of HPODs about the consequences of combined pathology did not much influence, but rather reflected the tendency to influence treatment adherence.