New York: HIV Patients' Drug Regimens Upset by September 11th

A study of HIV-positive New York men taking a complex regimen of antiviral drugs found a steep rise in missing or late doses after last September's attacks.

Lead author Dr. Perry Halkitis and colleagues calculated the frequency of missed dosages among 68 gay and bisexual men in New York who were prescribed highly active antiretroviral therapy (HAART). Study participants were interviewed, and their viral loads were monitored. Microchips in their HAART medication bottles recorded each time the containers were opened. On average, study participants missed between two and three doses per week in the two weeks preceding September 11. But in the two weeks immediately following the attacks, the figure jumped to five missed doses per week.

"Adherence to the difficult pill regimen is maximized when people have lives that are less complicated and when they have a routine," said Alix Kutnick, project director of the Protease Inhibitor Longitudinal Life Study (Project PILLS). "And in New York, it was so intense at that time it sort of threw people for a loop." The PILLS findings, an outgrowth of a study being conducted by the New York University-affiliated Center for HIV Educational Research and Training, were published last week by GayHealth.com.

The psychological factors critical to regimen adherence, such as confidence levels and coping skills, were badly compromised by the attacks, the researchers concluded. Higher levels of anxiety, uncertainty and grief are probably to blame, they suggested.

Kutnick and the PILLS team noticed the September 11th effect at the one-year mark of a three-year study assessing long-term HAART compliance. The researchers, who are still completing the larger study, will explore whether safe sex practices also dropped among study participants and what long-lasting impact the attacks had on HAART adherence.

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