Garin Noe, Zurita Beatriz, Velasco Cesar, Feliu Anna, Gutierrez Mar, Masip Montserrat, Mangues M Antonia
Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
BMJ Open. 2017 Jan 18;7(1):e014105. doi: 10.1136/bmjopen-2016-014105.
Drug interactions, poor adherence to medication and high-risk sexual behaviour may occur in individuals with HIV using recreational drugs. Thus, we aimed to assess the prevalence of recreational drugs use and to explore its clinical impact in HIV patients on treatment.
Observational, cross sectional, study conducted in a 700 bed university hospital, Barcelona, Spain. A total of 208 adults living with HIV on treatment were included. A questionnaire was administered by clinical pharmacists, including evaluation of sociodemographic variables, past 12-month drug consumption, adherence to antiretrovirals (Simplified Medication Adherence Questionnaire) and high-risk sexual behaviour (condomless sex/multiple partners). Additional data were obtained from clinical records. Recreational drug-antiretroviral interactions were checked in reference databases. Prevalence was calculated for 5% precision and 95% CI. Crude and adjusted binary logistic regressions were performed to identify associations between recreational drug use and adherence problems, and between recreational drug use and high-risk sexual behaviour.
From the overall sample, 92 participants (44.2%) consumed recreational drugs over the past 1 year. Of these, 44 (48.8%) had used different types of recreational drugs in this period. We detected 11 recreational substances, including sildenafil and nitrites. The most consumed drugs were: cannabis (68.5%), cocaine (45.5%), nitrites (31.5%), sildenafil (28.3) and ecstasy (19.6%). Relevant interactions occurred in 46 (50%) of the individuals consuming drugs. Recreational drug consumption was found to be related to adherence problems with antiretrovirals (OR: 2.51 (95% CI 1.32 to 4.77) p=0.005) and high-risk sexual behaviour (OR: 2.81 (95% CI 1.47 to 5.39) p=0.002).
Recreational drugs are frequently used by HIV patients on treatment. Classical drugs and new substances consumed in sexual context are usual. Recreational drug consumption interferes with several clinical outcomes, including potentially relevant interactions between drugs and antiretrovirals, adherence problems and high-risk sexual behaviour. Thus, there is the urgent need of implementing patient-centred care involving recreational drug consumption.
感染艾滋病毒且使用消遣性药物的个体可能会出现药物相互作用、服药依从性差以及高危性行为。因此，我们旨在评估消遣性药物的使用 prevalence，并探讨其对接受治疗的艾滋病毒患者的临床影响。
在西班牙巴塞罗那一家拥有700张床位的大学医院进行观察性横断面研究。共纳入208名接受治疗的成年艾滋病毒感染者。由临床药剂师发放问卷，内容包括社会人口统计学变量评估、过去12个月的药物 consumption、抗逆转录病毒药物的依从性（简化药物依从性问卷）以及高危性行为（无保护性行为/多个性伴侣）。从临床记录中获取其他数据。在参考数据库中检查消遣性药物与抗逆转录病毒药物的相互作用。计算患病率，精度为5%，置信区间为95%。进行粗逻辑回归和调整逻辑回归，以确定消遣性药物使用与依从性问题之间以及消遣性药物使用与高危性行为之间的关联。
在整个样本中，92名参与者（44.2%）在过去1年中使用过消遣性药物。其中，44名（48.8%）在此期间使用过不同类型的消遣性药物。我们检测到11种消遣性物质，包括西地那非和亚硝酸盐。使用最多的药物为：大麻（68.5%）、可卡因（45.5%）、亚硝酸盐（31.5%）、西地那非（28.3%）和摇头丸（19.6%）。46名（50%）使用药物的个体发生了相关相互作用。发现消遣性药物使用与抗逆转录病毒药物的依从性问题（比值比：2.51（95%置信区间1.32至4.77）p = 0.005）以及高危性行为（比值比：2.81（95%置信区间1.47至5.39）p = 0.002）有关。
接受治疗的艾滋病毒患者经常使用消遣性药物。在性方面使用的传统药物和新物质很常见。消遣性药物使用会干扰多种临床结局，包括药物与抗逆转录病毒药物之间潜在的相关相互作用、依从性问题和高危性行为。因此，迫切需要实施以患者为中心的护理，包括消遣性药物使用问题。
