Adherence to HIV Therapy in Drug Users in New Orleans This proposal is designed to explore adherence to new HIV treatment regimens in a population with a history of drug use attending the HIV Outpatient Program of the Medical Center of Louisiana (HOP) in New Orleans. Adherence to chronic drug therapy is an important factor in modifying the effectiveness of these new treatments. New combination antiretroviral drug therapies promise to convert HIV into a chronic disease. Yet, the complexity of antiretroviral drug regimens. side effects. and the changing population of AIDS patients may increase the likelihood of non-adherence with these chronically-used drugs. Unfortunately, even relatively modest non-adherence with some of the combination regimens. particularly those which include a protease inhibitor, may lead to viral resistance, reversed progression of HIV I disease and ineffectiveness of multiple antiretroviral drugs. Equally, a comprehensive model of adherence does not exist for this or any population. This proposal, conducted by Tulane University in collaboration with Louisiana State University and Women with a Vision, an African-American community based organization with a history of work with I IDUs. is a unique effort to explore the social, cultural and personal factors which contribute to adherence or non-adherence. This project will: 1) analyze an inner-city drug-using population that is demographically similar to the I upcoming generation of AIDS patients: 2) use a mix of methods to corroborate adherence. including comparing clinic and i prescription claims data, and self-report; 3) involves ethnography in exploring adherence issues; and 4) explores social network influence theories and social network analysis methods to account for adherence behaviors.
