Predictors of nonadherence to HIV-related medication regimens during methadone stabilization

Nonadherence to HIV-related medication regimens among dr drug-abusing Patie nts decreases therapeutic effectiveness and may limit patient access to new er, highly active antiretroviral therapies (HAART). A number of factors hav e been associated with medication nonadherence; however, few studies have e xamined predictors of nonadherence specifically in HIV-positive drug abuser s. In the current study, a comprehend ive assessment battery was administer ed to 42 HIV-positive, injection drug users; beginning methadone maintenanc e. HIV-related medication adherence was assessed weekly by self-report duri ng the 4-week methadone stabilization phase. Thirty-six percent of patients reported less than 80% adherence to their medication regimen at entry into methadone. Medication adherence increased significantly during the 4-week, stabilization phase. Significant zero-order correlations were found betwee n nonadherence during stabilization and viral load, low educational attainm ent, depression, and neuropsychological tests of problem solving ability an d cognitive flexibility. Independent predictors of nonadherence were low le vels of education and poor emotional functioning. Implications for early in tervention are discussed.