Community and Provider Perspectives on Improving Treatment Adherence and Retention for Injection Drug Users Living with HIV/AIDS: A Pilot Project

People who use injection drugs (IDUs) often have to cope with having multiple conditions that occur along with addiction, and those living with HIV/AIDS tend to have the poorest outcomes. Combining addiction care (methadone maintenance therapy, or MMT) and HIV care (highly active antiretroviral therapy, or HAART) in a community setting has the potential to improve short and long term outcomes for this population. However, key community members have identified that there remain considerable challenges to consistently taking medications and remaining on treatment (MMT and HAART) due a number of other factors, such as: a lack of stable housing, coexisting mental health problems, and experiences of stigma and discrimination when attempting to access health care services. The purpose of the research is to obtain better understanding of what factors contribute to IDUs who are living with HIV/AIDS not taking their medications regularly and staying on treatment (MMT and HAART), and also what supports have contributed to successfully taking medications and staying on treatment. We will start by looking at what other research can tell us about the best ways to improve the treatment and health outcomes of IDUs who are living with HIV/AIDS. We will be interviewing up to 12 male and female formal current and former clients of Direction 180 and Mainline who have experience with both treatments, MMT and HAART. We will also speak with up to 8 service providers who work directly with these individuals. By speaking with these groups, we will get a better idea of their daily experiences living with (and providing services for) addiction and HIV/AIDS and also obtain an understanding of the things that contribute to being able to take medications regularly and stay on treatment or not. Results of this study will be used to develop a larger study involving community-based organizations and researchers to address treatment models and policies across communities in Atlantic Canada.