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Substance Use and Adherence to Antiretroviral Therapy: What Is Known and What Is Unknown

  • HIV/AIDs (C Yoon, Section Editor)
  • Published:
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Abstract

Purpose of Review

People who use drugs face multiple challenges to achieve optimal HIV treatment outcomes. This review discusses the current knowledge in substance use and antiretroviral therapy adherence, highlighting recent findings and potential interventions.

Recent Findings

Studies continue to demonstrate the negative impacts of substance use and related disorders on antiretroviral therapy adherence, with the exception of cannabis. Evidence-based addiction treatment, in particular, opioid agonist therapy, appears to improve adherence levels. Most individual-level adherence specific interventions did not provide sustained effects, and no studies evaluating structural-level interventions were found.

Summary

Findings suggest the urgent need to scale-up opioid agonist therapy, as well as to simultaneously address multiple structural barriers to care to optimize HIV treatment outcomes among people who use drugs.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Funding

MES is supported by Michael Smith Foundation for Health Research (MSFHR) and Canadian Institutes of Health Research (CIHR) fellowship awards. M-JM is supported in part by NIH (U01-DA021525), a Scholar Award from MSFHR and a New Investigator award from the Canadian Institutes of Health Research (CIHR).

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Authors and Affiliations

  1. British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada

    M. Eugenia Socias & M-J Milloy

  2. Department of Medicine, University of British Columbia, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    M. Eugenia Socias & M-J Milloy

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  1. M. Eugenia Socias
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Correspondence to M-J Milloy.

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M. Eugenia Socías and MJ Milloy declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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M-JM’s institution has received an unstructured gift to support him from NG Biomed Ltd., a private firm seeking a government license to produce medical cannabis.

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This article is part of the Topical Collection on HIV/AIDs

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Socias, M.E., Milloy, MJ. Substance Use and Adherence to Antiretroviral Therapy: What Is Known and What Is Unknown. Curr Infect Dis Rep 20, 36 (2018). https://doi.org/10.1007/s11908-018-0636-7

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