The association of psychiatric medication use with adherence in patients with HIV

Over two million new cases of HIV infection will occur annually, worldwide. Triple drug anti-retroviral therapy (ART) decreases the viral load in patients with HIV, helping to stop progression of HIV infection to AIDs. Our study assessed how pharmacologic treatment for mental health issues affects medication adherence and viral load in patients with HIV. We conducted a retrospective chart review of 163 patients with HIV who had at least 2 visits at the HIV-clinic at Ascension St.John Hospital. Data were collected on demographics, medications, CD4 counts and viral loads. Data were analyzed using Student's t-test, the (2) test, the Mann-Whitney U test and logistic regression. Poor Compliance was defined as at least 2 consecutive visits with a CD4 count <200 mu L and/or with viral load 100IU/ml. Patients taking antidepressants were less likely to have poor compliance than those not on anti-depressants (6.3% vs. 22.3%, p=0.04). A similar association was found for patients taking any psychiatric drug (7.0% vs. 23.5%, p=0.02). On multivariable analysis, the odds of poor compliance were 6.3 times higher in patients who stopped HIV therapy for greater than one week between visits (p=0.004) and 3.6 times lower in patients taking any psychiatric medication (p=0.05).