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Erschienen in: AIDS and Behavior 8/2012

01.11.2012 | Original Paper

HIV-Infected Individuals with Co-occurring Bipolar Disorder Evidence Poor Antiretroviral and Psychiatric Medication Adherence

verfasst von: David J. Moore, Carolina Posada, Mili Parikh, Miguel Arce, Florin Vaida, Patricia K. Riggs, Ben Gouaux, Ronald J. Ellis, Scott L. Letendre, Igor Grant, J. Hampton Atkinson, The HIV Neurobahavioral Research Program (HNRP)

Erschienen in: AIDS and Behavior | Ausgabe 8/2012

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Abstract

The contribution of bipolar disorder (BD), a prevalent serious mental illness characterized by impulsivity and mood instability, to antiretroviral (ART) and psychiatric medication adherence among HIV-infected (HIV+) individuals is unknown. We examined medication adherence among 44 HIV+/BD+ persons as compared to 33 demographically- and medically-comparable HIV+/BD− persons. Classification of adherent (≥90%) or non-adherent (<90%) based on proportion of correctly taken doses over 30 days was determined using electronic medication monitoring devices. HIV+/BD+ persons were significantly less likely to be ART adherent (47.7%) as compared to HIV+/BD− (90.9%) persons. Within the HIV+/BD+ group, mean psychiatric medication adherence was significantly worse than ART medication adherence, although there was a significant correlation between ART and psychiatric adherence levels. Importantly, 30-day ART adherence was associated with plasma virologic response among HIV+/BD+ individuals. Given the high overlap of HIV and BD, and the observed medication adherence difficulties for these persons, specialized adherence improvement interventions are needed.
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Literatur
1.
Zurück zum Zitat Gifford AL, Bormann JE, Shively MJ, Wright BC, Richman DD, Bozzette SA. Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. J Acquir Immune Defic Syndr. 2000;23(5):386–95.PubMedCrossRef Gifford AL, Bormann JE, Shively MJ, Wright BC, Richman DD, Bozzette SA. Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. J Acquir Immune Defic Syndr. 2000;23(5):386–95.PubMedCrossRef
2.
Zurück zum Zitat Descamps D, Flandre P, Calvez V, et al. Mechanisms of virologic failure in previously untreated HIV-infected patients from a trial of induction-maintenance therapy. Trilege (Agence Nationale de Recherches sur le SIDA 072 Study Team). JAMA. 2000;283(2):205–11.PubMedCrossRef Descamps D, Flandre P, Calvez V, et al. Mechanisms of virologic failure in previously untreated HIV-infected patients from a trial of induction-maintenance therapy. Trilege (Agence Nationale de Recherches sur le SIDA 072 Study Team). JAMA. 2000;283(2):205–11.PubMedCrossRef
3.
Zurück zum Zitat Montaner JS, Reiss P, Cooper D, et al. A randomized, double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients: the INCAS trial. Italy, The Netherlands, Canada and Australia study. JAMA. 1998;279(12):930–7.PubMedCrossRef Montaner JS, Reiss P, Cooper D, et al. A randomized, double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients: the INCAS trial. Italy, The Netherlands, Canada and Australia study. JAMA. 1998;279(12):930–7.PubMedCrossRef
4.
Zurück zum Zitat Race E, Dam E, Obry V, Paulous S, Clavel F. Analysis of HIV cross-resistance to protease inhibitors using a rapid single-cycle recombinant virus assay for patients failing on combination therapies. AIDS. 1999;13(15):2061–8.PubMedCrossRef Race E, Dam E, Obry V, Paulous S, Clavel F. Analysis of HIV cross-resistance to protease inhibitors using a rapid single-cycle recombinant virus assay for patients failing on combination therapies. AIDS. 1999;13(15):2061–8.PubMedCrossRef
5.
Zurück zum Zitat Harrigan PR, Wynhoven B, Brumme ZL, et al. HIV-1 drug resistance: degree of underestimation by a cross-sectional versus a longitudinal testing approach. J Infect Dis. 2005;191(8):1325–30.PubMedCrossRef Harrigan PR, Wynhoven B, Brumme ZL, et al. HIV-1 drug resistance: degree of underestimation by a cross-sectional versus a longitudinal testing approach. J Infect Dis. 2005;191(8):1325–30.PubMedCrossRef
6.
Zurück zum Zitat Kalichman SC, Cherry C, Amaral CM, et al. Adherence to antiretroviral therapy and HIV transmission risks: implications for test-and-treat approaches to HIV prevention. AIDS Patient Care STDS. 2010;24(5):271–7.PubMedCrossRef Kalichman SC, Cherry C, Amaral CM, et al. Adherence to antiretroviral therapy and HIV transmission risks: implications for test-and-treat approaches to HIV prevention. AIDS Patient Care STDS. 2010;24(5):271–7.PubMedCrossRef
7.
Zurück zum Zitat Atkinson JH, Heaton RK, Patterson TL, et al. Two-year prospective study of major depressive disorder in HIV-infected men. J Affect Disord. 2008;108(3):225–34.PubMedCrossRef Atkinson JH, Heaton RK, Patterson TL, et al. Two-year prospective study of major depressive disorder in HIV-infected men. J Affect Disord. 2008;108(3):225–34.PubMedCrossRef
8.
Zurück zum Zitat Bing EG, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58(8):721–8.PubMedCrossRef Bing EG, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58(8):721–8.PubMedCrossRef
9.
Zurück zum Zitat Kilbourne AM, Justice AC, Rollman BL, et al. Clinical importance of HIV and depressive symptoms among veterans with HIV infection. J Gen Intern Med. 2002;17(7):512–20.PubMedCrossRef Kilbourne AM, Justice AC, Rollman BL, et al. Clinical importance of HIV and depressive symptoms among veterans with HIV infection. J Gen Intern Med. 2002;17(7):512–20.PubMedCrossRef
10.
Zurück zum Zitat Sternhell PS, Corr MJ. Psychiatric morbidity and adherence to antiretroviral medication in patients with HIV/AIDS. Aust N Z J Psychiatry. 2002;36(4):528–33.PubMedCrossRef Sternhell PS, Corr MJ. Psychiatric morbidity and adherence to antiretroviral medication in patients with HIV/AIDS. Aust N Z J Psychiatry. 2002;36(4):528–33.PubMedCrossRef
11.
Zurück zum Zitat Arnsten JH, Demas PA, Grant RW, et al. Impact of active drug use on antiretroviral therapy adherence and viral suppression in HIV-infected drug users. J Gen Intern Med. 2002;5:377–81. Arnsten JH, Demas PA, Grant RW, et al. Impact of active drug use on antiretroviral therapy adherence and viral suppression in HIV-infected drug users. J Gen Intern Med. 2002;5:377–81.
12.
Zurück zum Zitat DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000;160(14):2101–7.PubMedCrossRef DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000;160(14):2101–7.PubMedCrossRef
13.
Zurück zum Zitat Singh N, Squier C, Sivek C, Nguyen MH, Wagener M, Yu VL. Determinants of nontraditional therapy use in patients with HIV infection. A prospective study. Arch Intern Med. 1996;156(2):197–201.PubMedCrossRef Singh N, Squier C, Sivek C, Nguyen MH, Wagener M, Yu VL. Determinants of nontraditional therapy use in patients with HIV infection. A prospective study. Arch Intern Med. 1996;156(2):197–201.PubMedCrossRef
14.
Zurück zum Zitat Starace F, Ammassari A, Trotta MP, et al. Depression is a risk factor for suboptimal adherence to highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2002;15(31 Suppl 3):S136–9. Starace F, Ammassari A, Trotta MP, et al. Depression is a risk factor for suboptimal adherence to highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2002;15(31 Suppl 3):S136–9.
15.
Zurück zum Zitat Kumar V, Encinosa W. Effects of antidepressant treatment on antiretroviral regimen adherence among depressed HIV-infected patients. Psychiatr Q. 2009;80(3):131–41.PubMedCrossRef Kumar V, Encinosa W. Effects of antidepressant treatment on antiretroviral regimen adherence among depressed HIV-infected patients. Psychiatr Q. 2009;80(3):131–41.PubMedCrossRef
16.
Zurück zum Zitat Merikangas KR, Akiskal HS, Angst J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64(5):543–52.PubMedCrossRef Merikangas KR, Akiskal HS, Angst J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64(5):543–52.PubMedCrossRef
17.
Zurück zum Zitat Cournos F, McKinnon K. HIV seroprevalence among people with severe mental illness in the United States: a critical review. Clin Psychol Rev. 1997;17(3):259–69.PubMedCrossRef Cournos F, McKinnon K. HIV seroprevalence among people with severe mental illness in the United States: a critical review. Clin Psychol Rev. 1997;17(3):259–69.PubMedCrossRef
18.
Zurück zum Zitat Walkup J, Crystal S, Sambamoorthi U. Schizophrenia and major affective disorder among Medicaid recipients with HIV/AIDS in New Jersey. Am J Public Health. 1999;89(7):1101–3.PubMedCrossRef Walkup J, Crystal S, Sambamoorthi U. Schizophrenia and major affective disorder among Medicaid recipients with HIV/AIDS in New Jersey. Am J Public Health. 1999;89(7):1101–3.PubMedCrossRef
19.
Zurück zum Zitat Evans DL, Charney DS. Mood disorders and medical illness: a major public health problem. Biol Psychiatry. 2003;54(3):177–80.PubMedCrossRef Evans DL, Charney DS. Mood disorders and medical illness: a major public health problem. Biol Psychiatry. 2003;54(3):177–80.PubMedCrossRef
20.
Zurück zum Zitat Beyer J, Kuchibhatla M, Gersing K, Krishnan KR. Medical comorbidity in a bipolar outpatient clinical population. Neuropsychopharmacology. 2005;30(2):401–4.PubMedCrossRef Beyer J, Kuchibhatla M, Gersing K, Krishnan KR. Medical comorbidity in a bipolar outpatient clinical population. Neuropsychopharmacology. 2005;30(2):401–4.PubMedCrossRef
21.
Zurück zum Zitat Beyer JL, Taylor L, Gersing KR, Krishnan KR. Prevalence of HIV infection in a general psychiatric outpatient population. Psychosomatics. 2007;48(1):31–7.PubMedCrossRef Beyer JL, Taylor L, Gersing KR, Krishnan KR. Prevalence of HIV infection in a general psychiatric outpatient population. Psychosomatics. 2007;48(1):31–7.PubMedCrossRef
22.
Zurück zum Zitat Atkinson J, Young C, Pham T, et al., editors. Prioritizing adherence intervention based on self assessment. New Haven: Enhancing Adherence: A State of the Science Meeting on Intervention Research to Improve Anti-Retroviral Adherence; 2005. Atkinson J, Young C, Pham T, et al., editors. Prioritizing adherence intervention based on self assessment. New Haven: Enhancing Adherence: A State of the Science Meeting on Intervention Research to Improve Anti-Retroviral Adherence; 2005.
23.
Zurück zum Zitat Druss BG, Wang PS, Sampson NA, et al. Understanding mental health treatment in persons without mental diagnoses: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2007;64(10):1196–203.PubMedCrossRef Druss BG, Wang PS, Sampson NA, et al. Understanding mental health treatment in persons without mental diagnoses: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2007;64(10):1196–203.PubMedCrossRef
24.
Zurück zum Zitat Robins LN, Wing J, Wittchen HU, et al. The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry. 1988;45(12):1069–77.PubMedCrossRef Robins LN, Wing J, Wittchen HU, et al. The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry. 1988;45(12):1069–77.PubMedCrossRef
25.
Zurück zum Zitat Walkup J, Blank MB, Gonzalez JS, et al. The impact of mental health and substance abuse factors on HIV prevention and treatment. J Acquir Immune Defic Syndr. 2008;47(Suppl 1):S15–9.PubMed Walkup J, Blank MB, Gonzalez JS, et al. The impact of mental health and substance abuse factors on HIV prevention and treatment. J Acquir Immune Defic Syndr. 2008;47(Suppl 1):S15–9.PubMed
26.
Zurück zum Zitat Scott J, Pope M. Nonadherence with mood stabilizers: prevalence and predictors. J Clin Psychiatry. 2002;63(5):384–90.PubMedCrossRef Scott J, Pope M. Nonadherence with mood stabilizers: prevalence and predictors. J Clin Psychiatry. 2002;63(5):384–90.PubMedCrossRef
27.
Zurück zum Zitat Li J, McCombs JS, Stimmel GL. Costs of treating bipolar disorder in the California Medicaid (Medi-Cal) program. J Affect Disord. 2002;71(1–3):131–9.PubMedCrossRef Li J, McCombs JS, Stimmel GL. Costs of treating bipolar disorder in the California Medicaid (Medi-Cal) program. J Affect Disord. 2002;71(1–3):131–9.PubMedCrossRef
28.
Zurück zum Zitat Berk M, Berk L, Castle D. A collaborative approach to the treatment alliance in bipolar disorder. Bipolar Disord. 2004;6(6):504–18.PubMedCrossRef Berk M, Berk L, Castle D. A collaborative approach to the treatment alliance in bipolar disorder. Bipolar Disord. 2004;6(6):504–18.PubMedCrossRef
29.
Zurück zum Zitat Keller MB. Improving the course of illness and promoting continuation of treatment of bipolar disorder. J Clin Psychiatry. 2004;65(Suppl 15):10–4.PubMed Keller MB. Improving the course of illness and promoting continuation of treatment of bipolar disorder. J Clin Psychiatry. 2004;65(Suppl 15):10–4.PubMed
30.
Zurück zum Zitat Wagner GJ, Kanouse DE, Koegel P, Sullivan G. Adherence to HIV antiretrovirals among persons with serious mental illness. AIDS Patient Care STDS. 2003;17(4):179–86.PubMedCrossRef Wagner GJ, Kanouse DE, Koegel P, Sullivan G. Adherence to HIV antiretrovirals among persons with serious mental illness. AIDS Patient Care STDS. 2003;17(4):179–86.PubMedCrossRef
31.
Zurück zum Zitat Wagner GJ, Kanouse DE, Koegel P, Sullivan G. Correlates of HIV antiretroviral adherence in persons with serious mental illness. AIDS Care. 2004;16(4):501–6.PubMedCrossRef Wagner GJ, Kanouse DE, Koegel P, Sullivan G. Correlates of HIV antiretroviral adherence in persons with serious mental illness. AIDS Care. 2004;16(4):501–6.PubMedCrossRef
32.
Zurück zum Zitat Himelhoch S, Brown CH, Walkup J, et al. HIV patients with psychiatric disorders are less likely to discontinue HAART. AIDS. 2009;23(13):1735–42.PubMedCrossRef Himelhoch S, Brown CH, Walkup J, et al. HIV patients with psychiatric disorders are less likely to discontinue HAART. AIDS. 2009;23(13):1735–42.PubMedCrossRef
33.
Zurück zum Zitat Walkup J, Wei W, Sambamoorthi U, Crystal S. Antidepressant treatment and adherence to combination antiretroviral therapy among patients with AIDS and diagnosed depression. Psychiatr Q. 2008;79(1):43–53.PubMedCrossRef Walkup J, Wei W, Sambamoorthi U, Crystal S. Antidepressant treatment and adherence to combination antiretroviral therapy among patients with AIDS and diagnosed depression. Psychiatr Q. 2008;79(1):43–53.PubMedCrossRef
34.
Zurück zum Zitat Walkup JT, Sambamoorthi U, Crystal S. Use of newer antiretroviral treatments among HIV-infected medicaid beneficiaries with serious mental illness. J Clin Psychiatry. 2004;65(9):1180–9.PubMedCrossRef Walkup JT, Sambamoorthi U, Crystal S. Use of newer antiretroviral treatments among HIV-infected medicaid beneficiaries with serious mental illness. J Clin Psychiatry. 2004;65(9):1180–9.PubMedCrossRef
35.
Zurück zum Zitat Kemppainen JK, Levine R, Buffum M, Holzemer W, Finley P, Jensen P. Antiretroviral adherence in persons with HIV/AIDS and severe mental illness. J Nerv Ment Dis. 2004;192(6):395–404.PubMedCrossRef Kemppainen JK, Levine R, Buffum M, Holzemer W, Finley P, Jensen P. Antiretroviral adherence in persons with HIV/AIDS and severe mental illness. J Nerv Ment Dis. 2004;192(6):395–404.PubMedCrossRef
36.
Zurück zum Zitat Young RC, Biggs J, Ziegler V, Meyer D. A rating scale for mania: reliability, validity, and sensitivity. Br J Psychiatry. 1978;133:429–35.PubMedCrossRef Young RC, Biggs J, Ziegler V, Meyer D. A rating scale for mania: reliability, validity, and sensitivity. Br J Psychiatry. 1978;133:429–35.PubMedCrossRef
37.
Zurück zum Zitat Beck AT, Steer RA, Brown G. BDI-II manual. San Antonio: The Psychological Corp; 1996. Beck AT, Steer RA, Brown G. BDI-II manual. San Antonio: The Psychological Corp; 1996.
38.
Zurück zum Zitat Hall RC. Global assessment of functioning. A modified scale. Psychosomatics. 1995;36(3):267–75.PubMedCrossRef Hall RC. Global assessment of functioning. A modified scale. Psychosomatics. 1995;36(3):267–75.PubMedCrossRef
39.
Zurück zum Zitat Vriesendorp R, Cohen A, Kristanto P, et al. Adherence to HAART therapy measured by electronic monitoring in newly diagnosed HIV patients in Botswana. Eur J Clin Pharmacol. 2007;63(12):1115–21.PubMedCrossRef Vriesendorp R, Cohen A, Kristanto P, et al. Adherence to HAART therapy measured by electronic monitoring in newly diagnosed HIV patients in Botswana. Eur J Clin Pharmacol. 2007;63(12):1115–21.PubMedCrossRef
40.
Zurück zum Zitat Twagirumukiza M, Kayumba PC, Kips JG, et al. Evaluation of medication adherence methods in the treatment of malaria in Rwandan infants. Malar J. 2010;9:206. Twagirumukiza M, Kayumba PC, Kips JG, et al. Evaluation of medication adherence methods in the treatment of malaria in Rwandan infants. Malar J. 2010;9:206.
41.
Zurück zum Zitat Liu H, Golin CE, Miller LG, et al. A comparison study of multiple measures of adherence to HIV protease inhibitors. Ann Intern Med. 2001;134(10):968–77.PubMed Liu H, Golin CE, Miller LG, et al. A comparison study of multiple measures of adherence to HIV protease inhibitors. Ann Intern Med. 2001;134(10):968–77.PubMed
42.
Zurück zum Zitat Applebaum AJ, Reilly LC, Gonzalez JS, Richardson MA, Leveroni CL, Safren SA. The impact of neuropsychological functioning on adherence to HAART in HIV-infected substance abuse patients. AIDS Patient Care STDS. 2009;23(6):455–62.PubMedCrossRef Applebaum AJ, Reilly LC, Gonzalez JS, Richardson MA, Leveroni CL, Safren SA. The impact of neuropsychological functioning on adherence to HAART in HIV-infected substance abuse patients. AIDS Patient Care STDS. 2009;23(6):455–62.PubMedCrossRef
43.
Zurück zum Zitat McAllister-Williams RH. Relapse prevention in bipolar disorder: a critical review of current guidelines. J Psychopharmacol. 2006;20(2 Suppl):12–6.PubMedCrossRef McAllister-Williams RH. Relapse prevention in bipolar disorder: a critical review of current guidelines. J Psychopharmacol. 2006;20(2 Suppl):12–6.PubMedCrossRef
44.
Zurück zum Zitat Lu M, Rogers WH, Laws MB, et al. Covered Time (CT) vs. Percent Doses Taken (PDT): comparing two MEMS summary adherence measures using Viral Loads (VL) as reference. Jersey City: Third International Conference of HIV Treatment Adherence; 2008. Lu M, Rogers WH, Laws MB, et al. Covered Time (CT) vs. Percent Doses Taken (PDT): comparing two MEMS summary adherence measures using Viral Loads (VL) as reference. Jersey City: Third International Conference of HIV Treatment Adherence; 2008.
45.
Zurück zum Zitat Singh N, Berman SM, Swindells S, et al. Adherence of human immunodeficiency virus-infected patients to antiretroviral therapy. Clin Infect Dis. 1999;29(4):824–30.PubMedCrossRef Singh N, Berman SM, Swindells S, et al. Adherence of human immunodeficiency virus-infected patients to antiretroviral therapy. Clin Infect Dis. 1999;29(4):824–30.PubMedCrossRef
46.
Zurück zum Zitat Ellis RJ, Childers ME, Zimmerman JD, Simon DWF, Deutsch R, McCutchan JA. Human immunodeficiency virus-1 RNA levels in cerebrospinal fluid exhibit a set point in clinically stable patients not receiving antiretroviral therapy. J Infect Dis. 2003;187(11):1818–21.PubMedCrossRef Ellis RJ, Childers ME, Zimmerman JD, Simon DWF, Deutsch R, McCutchan JA. Human immunodeficiency virus-1 RNA levels in cerebrospinal fluid exhibit a set point in clinically stable patients not receiving antiretroviral therapy. J Infect Dis. 2003;187(11):1818–21.PubMedCrossRef
47.
Zurück zum Zitat R Development Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2010. R Development Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2010.
48.
Zurück zum Zitat SAS Institute. JMP® 8 User Guide. Second Edition ed. Cary: SAS Institute Inc; 2009. SAS Institute. JMP® 8 User Guide. Second Edition ed. Cary: SAS Institute Inc; 2009.
50.
Zurück zum Zitat Wendel CS, Mohler MJ, Kroesen K, Ampel NM, Gifford AL, Coons SJ. Barriers to use of electronic adherence monitoring in an HIV clinic. Ann Pharmacother. 2001;35(9):1010–5.PubMedCrossRef Wendel CS, Mohler MJ, Kroesen K, Ampel NM, Gifford AL, Coons SJ. Barriers to use of electronic adherence monitoring in an HIV clinic. Ann Pharmacother. 2001;35(9):1010–5.PubMedCrossRef
51.
Zurück zum Zitat Levine AJ, Hinkin CH, Castellon SA, et al. Variations in patterns of highly active antiretroviral therapy (HAART) adherence. AIDS Behav. 2005;9(3):355–62.PubMedCrossRef Levine AJ, Hinkin CH, Castellon SA, et al. Variations in patterns of highly active antiretroviral therapy (HAART) adherence. AIDS Behav. 2005;9(3):355–62.PubMedCrossRef
Metadaten
Titel
HIV-Infected Individuals with Co-occurring Bipolar Disorder Evidence Poor Antiretroviral and Psychiatric Medication Adherence
verfasst von
David J. Moore
Carolina Posada
Mili Parikh
Miguel Arce
Florin Vaida
Patricia K. Riggs
Ben Gouaux
Ronald J. Ellis
Scott L. Letendre
Igor Grant
J. Hampton Atkinson
The HIV Neurobahavioral Research Program (HNRP)
Publikationsdatum
01.11.2012
Verlag
Springer US
Erschienen in
AIDS and Behavior / Ausgabe 8/2012
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-011-0072-2

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