Evidence map›Paper›PMID 39465466›Full record

ArticleAIDS and behavior2025

Severity and Number of Substances Used are Independently Associated with Antiretroviral Therapy Adherence Over Time among People with HIV in the Current Treatment Era.

Jimmy Ma, Joseph A C Delaney, Stephanie A Ruderman, Robin M Nance, Andrew W Hahn, Lydia N Drumright, Bridget M Whitney, Rob J Fredericksen, L Sarah Mixson, Joseph O Merrill and 17 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in AIDS and behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Antiretroviral therapy switch among Medicare beneficiaries with HIV.Journal of managed care & specialty pharmacy · 2026
    Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors.

Jimmy MaDepartment of Medicine, University of Washington, Seattle, WA, USA. jma52@uw.edu.ORCID http://orcid.org/0000-0002-6849-3206
Joseph A C DelaneyDepartment of Medicine, University of Washington, Seattle, WA, USA.
Stephanie A RudermanDepartment of Medicine, University of Washington, Seattle, WA, USA.
Robin M NanceDepartment of Medicine, University of Washington, Seattle, WA, USA.
Andrew W HahnDepartment of Medicine, University of Washington, Seattle, WA, USA.
Lydia N DrumrightDepartment of Medicine, University of Washington, Seattle, WA, USA.
Bridget M WhitneyDepartment of Medicine, University of Washington, Seattle, WA, USA.
Rob J FredericksenDepartment of Medicine, University of Washington, Seattle, WA, USA.
L Sarah MixsonDepartment of Medicine, University of Washington, Seattle, WA, USA.
Joseph O MerrillDepartment of Medicine, University of Washington, Seattle, WA, USA.
Steven A SafrenDepartment of Psychology, University of Miami, Coral Gables, FL, USA.
Kenneth H MayerThe Fenway Institute, Fenway Health, and Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA.
Conall O'CleirighThe Fenway Institute, Fenway Health, and Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA.
Sonia NapravnikDepartment of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Geetanjali ChanderDepartment of Medicine, University of Washington, Seattle, WA, USA.
Richard D MooreDepartment of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Katerina A ChristopoulosDepartment of Medicine, University of California, San Francisco, CA, USA.
Amanda L WilligDepartment of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Laura BamfordDepartment of Medicine, University of California, San Diego, CA, USA.
Allison WebelDepartment of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, USA.
Mary E McCaulDepartment of Psychiatry, Johns Hopkins University, Baltimore, MD, USA.
Edward R CachayDepartment of Medicine, University of California, San Diego, CA, USA.
Jeffrey M JacobsonDepartment of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Michael S SaagDepartment of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Mari M KitahataDepartment of Medicine, University of Washington, Seattle, WA, USA.
Heidi M CraneDepartment of Medicine, University of Washington, Seattle, WA, USA.
Emily C WilliamsDepartment of Health Systems and Population Health, University of Washington, Seattle, WA, USA.

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI CONNIE L CELUM · 1988 to 2026
$104.9M
Unsolicited R24 for the CFAR-Network of Integrated Clinical Sciences, CNICSR24AI067039 · NIAID · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Michael S. Saag · 2006 to 2026
$99.4M
The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI ARTHUR Y KIM · 2004 to 2026
$94.4M
Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STEVEN Grant DEEKS · 1988 to 2026
$93.6M
Virology CoreP30AI027767 · NIAID · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Paul A. Goepfert · 1988 to 2026
$84.1M
VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SUSAN JANET LITTLE · 1994 to 2026
$78.4M
Virology, Immunology, and Microbiology CoreP30AI050410 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DAVID M. MARGOLIS · 2001 to 2026
$76.9M
Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Anna Palmer Durbin · 2012 to 2026
$67.0M
WG3: HIV, Co-infections and Co-morbiditiesP30AI036219 · NIAID · CASE WESTERN RESERVE UNIVERSITY · PI Immaculate Lillian Nankya · 1994 to 2026
$50.0M
Johns Hopkins HIV Clinical CohortU01DA036935 · NIDA · JOHNS HOPKINS UNIVERSITY · PI MOORE, RICHARD DOUGLAS · 2014 to 2024
$14.9M
HOST DEFENSE TRAINING IN ALLERGY AND INFECTIOUS DISEASEST32AI007044 · NIAID · UNIVERSITY OF WASHINGTON · PI DAVID Neal FREDRICKS · 1985 to 2026
$14.6M
Alcohol Research Consortium in HIV: Relapse Prevention ArmP01AA029544 · NIAAA · JOHNS HOPKINS UNIVERSITY · PI CHANDER, GEETANJALI, MCCAUL, MARY E · 2021 to 2025
$7.1M
National Institute of Allergy and Infectious Diseases P30 AI50410National Institute of Allergy and Infectious Diseases T32AI007044NIAAA NIH HHS P01 AA029544NIAID NIH HHS P30 AI027757NIAID NIH HHS P30 AI027763NIAID NIH HHS P30 AI027767NIAID NIH HHS P30 AI036214NIAID NIH HHS P30 AI036219NIAID NIH HHS P30 AI050410NIAID NIH HHS P30 AI060354NIAID NIH HHS P30 AI094189NIAID NIH HHS R24 AI067039NIAID NIH HHS T32 AI007044NICHD NIH HHS P2C HD042828NIDA NIH HHS R01 DA047045NIDA NIH HHS R01 DA058938NIDA NIH HHS U01 DA036935NIH HHS P2C HD042828
6 · The paper itself

Abstract

Substance use is associated with decreased antiretroviral therapy (ART) adherence among people with HIV (PWH). Adherence plays a significant role in mediating the negative effects of substance use on HIV suppression and is a principal modifiable patient-level factor in improving HIV suppression and reducing ART drug resistance. Understanding substance use and ART adherence, particularly with rapidly changing substance use epidemiology and ART regimens, is vital to improving HIV care. Among 10,557 PWH (2010-2021) from 8 academic clinical sites nationally we examined longitudinal associations of substance use severity and number of substances used (measured using AUDIT-C and modified ASSIST) with patient-reported ART adherence (visual analog scale). Alcohol (68% any use, 18% unhealthy use [AUDIT-C > 4 men, > 3 women]), marijuana (33%), and methamphetamine (9%) use were most reported. Polysubstance use was common (32%). Both higher severity substance use and higher number of substances used were associated with lower ART adherence. Severity of methamphetamine use had the strongest dose-response association with ART adherence (low severity [ASSIST 1-3]: -3.05%, 95% CI: -4.23%, -1.87%; moderate [ASSIST 4-26]: -6.20%, 95% CI: -7.08%, -5.33%; high [ASSIST > 26]: -10.77%, 95% CI: -12.76%, -8.78%). Severe substance use, especially methamphetamine, and higher number of illicit drugs used were associated with declines in adherence at levels that were likely clinically meaningful in the modern era of ART. Findings support integrating substance use care with HIV care and potential benefits of harm reduction strategies for improving adherence such as encouraging lower levels of substance use and fewer number of substances used.

Indexed as

Anti-HIV AgentsHIV InfectionsMedication AdherenceSubstance-Related DisordersAdultFemaleHumansLongitudinal StudiesMaleMethamphetamineMiddle AgedSeverity of Illness IndexUnited StatesAnti-HIV AgentsMethamphetamineAdherenceAntiretroviral TherapyARTMethamphetamineSubstance use

Identifiers

PMID39465466
PMCPMC13051551

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.