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.