Engagement in Maximally-Assisted Therapy and Adherence to Antiretroviral Therapy Among a Cohort of Indigenous People Who Use Illicit Drugs

Brittany Barker; Evan Adams; Evan Wood; Thomas Kerr; Kora DeBeck; Huiru Dong; Jean Shoveller; Julio Montaner; M. J. Milloy

doi:10.1007/s10461-018-2226-y

Engagement in Maximally-Assisted Therapy and Adherence to Antiretroviral Therapy Among a Cohort of Indigenous People Who Use Illicit Drugs

Brittany Barker, Evan Adams, Evan Wood, Thomas Kerr, Kora DeBeck, Huiru Dong, Jean Shoveller, Julio Montaner, M. J. Milloy

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8 Citations (Scopus)

Résumé

Throughout the world, Indigenous populations experience a disproportionate burden of HIV infection. Maximally-assisted therapy (MAT) is an interdisciplinary care intervention that includes ART dispensation to support individuals with a history of addiction and homelessness. This study sought to longitudinally evaluate the relationship between engagement in MAT and achieving optimal adherence using data from an ongoing cohort of HIV-positive individuals who use drugs in Vancouver, Canada, where HIV/AIDS treatment is offered at no cost. Between December 2005 and November 2016, 354 HIV-positive Indigenous participants were enrolled and data were analyzed using generalized mixed-effects (GLMM) and marginal structural modeling. In both multivariable analyses, engagement in MAT was independently associated with optimal adherence to ART (GLMM: AOR = 4.92, 95% CI 3.18–7.62; marginal structural model: AOR = 5.76, 95% CI 3.34–9.96). MAT-based programmes could be a part of a renewed evidence-base to elevated levels of preventable HIV/AIDS-associated morbidity, mortality and viral transmission among Indigenous peoples in Canada.

Langue d'origine	English
Pages (de-à)	1258-1266
Nombre de pages	9
Journal	AIDS and Behavior
Volume	23
Numéro de publication	5
DOI	https://doi.org/10.1007/s10461-018-2226-y
Statut de publication	Published - mai 15 2019
Publié à l'externe	Oui

Note bibliographique

Funding Information:
Funding The study is supported by the US National Institutes of Health (U01-DA021525).

Funding Information:
Conflict of interest Dr. Milloy is supported in part by the US National Institutes of Health (U01-DA021525), a Scholar award from the Michael Smith Foundation for Health Research (MSFHR), and a New Investigator award from the Canadian Institutes of Health Research. Dr. Milloy and his institution have received an unstructured gift from NG Biomed, Ltd., a private firm seeking a license from the Canadian government to produce medical cannabis, to support him. This work was supported in part by a Tier 1 Canada Research Chair in Inner-City Medicine awarded to Dr. Wood. Dr. Montaner is supported by the British Columbia Ministry of Health and through an Avant-Garde Award (No. 1DP1DA026182) from the National Institute of Drug Abuse (NIDA), at the US National Institutes of Health (NIH). He has also received financial support from the International AIDS Society, United Nations AIDS Program, World Health Organization, NIH Office of AIDS Research, National Institute of Allergy and Infectious Diseases, The United States President’s Emergency Plan for AIDS Relief (PEP-fAR), UNICEF, the University of British Columbia, Simon Fraser University, Providence Health Care and Vancouver Coastal Health Authority. Dr. Kora DeBeck is supported by a MSFHR/St. Paul’s Hospital Foundation-Providence Health Care Career Scholar Award and a Canadian Institutes of Health Research New Investigator Award. Brittany Barker is supported by a Canadian Institutes of Health Research Doctoral Award. The funders had no role in the design and conduct of this study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.

ASJC Scopus Subject Areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

ODD de l’ONU

Cette action contribue à la réalisation des objectifs de développement durable suivants

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10.1007/s10461-018-2226-y

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title = "Engagement in Maximally-Assisted Therapy and Adherence to Antiretroviral Therapy Among a Cohort of Indigenous People Who Use Illicit Drugs",

abstract = "Throughout the world, Indigenous populations experience a disproportionate burden of HIV infection. Maximally-assisted therapy (MAT) is an interdisciplinary care intervention that includes ART dispensation to support individuals with a history of addiction and homelessness. This study sought to longitudinally evaluate the relationship between engagement in MAT and achieving optimal adherence using data from an ongoing cohort of HIV-positive individuals who use drugs in Vancouver, Canada, where HIV/AIDS treatment is offered at no cost. Between December 2005 and November 2016, 354 HIV-positive Indigenous participants were enrolled and data were analyzed using generalized mixed-effects (GLMM) and marginal structural modeling. In both multivariable analyses, engagement in MAT was independently associated with optimal adherence to ART (GLMM: AOR = 4.92, 95% CI 3.18–7.62; marginal structural model: AOR = 5.76, 95% CI 3.34–9.96). MAT-based programmes could be a part of a renewed evidence-base to elevated levels of preventable HIV/AIDS-associated morbidity, mortality and viral transmission among Indigenous peoples in Canada.",

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note = "Funding Information: Funding The study is supported by the US National Institutes of Health (U01-DA021525). Funding Information: Conflict of interest Dr. Milloy is supported in part by the US National Institutes of Health (U01-DA021525), a Scholar award from the Michael Smith Foundation for Health Research (MSFHR), and a New Investigator award from the Canadian Institutes of Health Research. Dr. Milloy and his institution have received an unstructured gift from NG Biomed, Ltd., a private firm seeking a license from the Canadian government to produce medical cannabis, to support him. This work was supported in part by a Tier 1 Canada Research Chair in Inner-City Medicine awarded to Dr. Wood. Dr. Montaner is supported by the British Columbia Ministry of Health and through an Avant-Garde Award (No. 1DP1DA026182) from the National Institute of Drug Abuse (NIDA), at the US National Institutes of Health (NIH). He has also received financial support from the International AIDS Society, United Nations AIDS Program, World Health Organization, NIH Office of AIDS Research, National Institute of Allergy and Infectious Diseases, The United States President{\textquoteright}s Emergency Plan for AIDS Relief (PEP-fAR), UNICEF, the University of British Columbia, Simon Fraser University, Providence Health Care and Vancouver Coastal Health Authority. Dr. Kora DeBeck is supported by a MSFHR/St. Paul{\textquoteright}s Hospital Foundation-Providence Health Care Career Scholar Award and a Canadian Institutes of Health Research New Investigator Award. Brittany Barker is supported by a Canadian Institutes of Health Research Doctoral Award. The funders had no role in the design and conduct of this study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Publisher Copyright: {\textcopyright} 2018, Springer Science+Business Media, LLC, part of Springer Nature.",

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Engagement in Maximally-Assisted Therapy and Adherence to Antiretroviral Therapy Among a Cohort of Indigenous People Who Use Illicit Drugs

Résumé

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ASJC Scopus Subject Areas

ODD de l’ONU

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