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Factors related to variations in TB treatment compliance among IDUs impacted by HIV - preliminary findings.




 

Int Conf AIDS. 1996 Jul 7-12;11(1):166 (abstract no. Mo.C.1651). Unique

Objective: To identify and examine factors that influence TB treatment regimen compliance among injecting drug users (IDUs) with, or at risk for, HIV. Methods: In response to a tuberculosis TB) outbreak originating among HIV + IDUs on the northwest side of Chicago, the University of Illinois at Chicago Community Outreach Intervention Project joined the Chicago Department of Health in a pilot project that applied the Indigenous Leader Outreach Model (ILOM) intervention previously used for HIV prevention - to target TB-infected individuals. The ILOM enlists ex-addict outreach workers to provide directly observed therapy DOT), preventive prophylaxis, and case management to IDUs, a group with low levels of TB treatment compliance and high levels of distrust of public health authorities. Qualitative data, in the form of observational fieldnotes and taped interviews with key informants, were collected to assess the impact of the intervention and examine factors related to TB treatment compliance among IDUs. Results: Preliminary findings regarding factors that influence TB treatment compliance among IDUs, include: 1) IDU residential patterns vary greatly, from stable, relatively permanent housing to living arrangements which are temporary and erratic (shelters, abandoned buildings, family members' homes, etc.), making DOT difficult. Further, certain living spaces also serve as a locus of drug procurement and administration (e.g.,"shooting galleries" or "rock" houses) resulting in a pattern of congregation that promotes transmission of TB and inhibits DOT. 3) Stigma associated with having TB can affect IDUs' ability to procure drugs or a place to sleep, and may be viewed as more harmful than the stigma associated with HIV. As a result, IDUs typically avoid public health measures that arouse suspicion or label an addict as having TB. 4) Individuals with a high level of drug addiction generally find that these needs require more attention than other "health needs," which compromises daily TB treatment regimens. Conclusion: The design of public health interventions to control TB among IDUs should take into account drug-using lifestyle factors which may greatly influence TB treatment compliance.

*HIV Infections/COMPLICATIONS *Patient Compliance *Substance Abuse, Intravenous *Tuberculosis/DRUG THERAPY



 




Information in this article was accurate in January 30, 1997. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.