{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:46:08Z","timestamp":1777895168953,"version":"3.51.4"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T00:00:00Z","timestamp":1637280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","award":["001\/2016"],"award-info":[{"award-number":["001\/2016"]}],"id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Drug use implies important challenges related to HIV management, particularly due to an increased risk of potential interactions between antiretroviral therapy (ART) and illicit drugs (pDDIs). This study analyses the prevalence and severity of pDDIs among people living with HIV (PLHIV). It also explores their awareness of pDDIs and their beliefs about the toxicity that they may cause, as well as the impact of pDDIs on selected health variables. We conducted an on-line cross-sectional survey across 33 Spanish hospitals and NGOs to collect demographics and clinical data. pDDIs were checked against the Interaction Checker developed by Liverpool University. The sample of the present study was composed of 694 PLHIV who used illicit drugs. They represented 49.5% of the 1,401 PLHIV that participated in the survey. After excluding 38 participants due to lack of information on their ART or illicit drug use, 335 (51.1%) participants consuming drugs presented with some potentially significant pDDIs between their ART and illicit drugs, with a mean of 2.1\u00b11.7 (1\u201310) pDDIs per patient. The drugs most frequently involved in pDDIs were cocaine, cannabis, MDMA and nitrates (\"<jats:italic>poppers<\/jats:italic>\"). The prevalence of pDDIs across ART regimens was: protease inhibitors (41.7%); integrase inhibitor-boosted regimens (32.1%), and non-nucleoside reverse transcriptase inhibitors (26.3%). An awareness of pDDIs and beliefs about their potential toxicity correlated positively with intentional non-adherence (p&lt;0.0001). Participants with pDDIs exhibited a higher prevalence of intentional non-adherence (2.19\u00b11.04 vs. 1.93\u00b10.94;<jats:italic>p<\/jats:italic>= 0.001). The presence of pDDIs was not associated with poorer results in the clinical variables analysed. A significant proportion of PLHIV who use drugs experience pDDIs, thereby requiring close monitoring. pDDIs should be considered in the clinical management of HIV patients. Adequate information about pDDIs and indicators about how to manage ART when PLHIV use drugs could improve ART non-adherence.<\/jats:p>","DOI":"10.1371\/journal.pone.0260334","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T18:33:14Z","timestamp":1637346794000},"page":"e0260334","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prevalence, beliefs and impact of drug-drug interactions between antiretroviral therapy and illicit drugs among people living with HIV in Spain"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0143-114X","authenticated-orcid":true,"given":"Vanessa","family":"Castro-Granell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"No\u00e9","family":"Garin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngeles","family":"Ja\u00e9n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Cenoz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4911-4071","authenticated-orcid":true,"given":"Mar\u00eda Jos\u00e9","family":"Galindo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Fuster-RuizdeApodaca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,11,19]]},"reference":[{"key":"pone.0260334.ref001","unstructured":"ONUSIDA. Hoja informativa: \u00faltimas estad\u00edsticas sobre el estado de la epidemia de sida (datos a cierre de 2019). 2020. Availablefrom: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/UNAIDS_FactSheet_es.pdf"},{"key":"pone.0260334.ref002","unstructured":"Unidad de vigilancia del VIH, ITS y hepatitis. Actualizaci\u00f3n del Continuo de Atenci\u00f3n del VIH en Espa\u00f1a, 2017\u20132019. Madrid: Centro Nacional de Epidemiolog\u00eda\u2013Instituto de Salud Carlos III \/ Plan Nacional sobre el Sida\u2013Direcci\u00f3n General de Salud P\u00fablica; 2020. Available from: https:\/\/www.mscbs.gob.es\/ciudadanos\/enfLesiones\/enfTransmisibles\/sida\/vigilancia\/ESTIMACION_DEL_CONTINUO_DE_ATENCIoN_DEL_VIH_EN_ESPAnA_Nov2020.pdf"},{"issue":"5","key":"pone.0260334.ref003","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1177\/1060028016685115","article-title":"Comparing the frequencies of contraindicated drug-drug interactions between differing antiretroviral regimens in HIV-infected patients","volume":"51","author":"B Jakeman","year":"2017","journal-title":"Ann Pharmacother"},{"issue":"1","key":"pone.0260334.ref004","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.22374\/1710-6222.26.1.1","article-title":"Clinically significant drug-drug interaction in a large antiretroviral treatment centre in Lagos, Nigeria","volume":"26","author":"IA Oreagba","year":"2019","journal-title":"J Popul Ther Clin 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HIV drug interactions webpage. http:\/\/www.hiv-druginteractions.org\/."},{"issue":"1","key":"pone.0260334.ref019","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.farma.2010.01.018","article-title":"Interacciones farmacol\u00f3gicas de los nuevos antirretrovirales","volume":"35","author":"J.I. Serrano L\u00f3pez de las Hazas","year":"2011","journal-title":"Farm Hosp"},{"issue":"6","key":"pone.0260334.ref020","doi-asserted-by":"crossref","first-page":"e0211252","DOI":"10.1371\/journal.pone.0211252","article-title":"Prevalence and patterns of illicit drug use in people living with HIV in Spain: A cross-sectional study","volume":"14","author":"MJ Fuster-RuizdeApodaca","year":"2019","journal-title":"PLoS One"},{"issue":"3\u20134","key":"pone.0260334.ref021","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s00508-010-1309-1","article-title":"Drug-drug interactions and adverse drug reactions: separating the wheat from the chaff","volume":"122","author":"M Pirmohamed","year":"2010","journal-title":"Wien Klin Wochenschr"},{"issue":"8","key":"pone.0260334.ref022","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1177\/0956462413479894","article-title":"Dilated common bile duct and deranged liver function tests associated with ketamine use in two HIV-positive MSM","volume":"24","author":"J Zhou","year":"2013","journal-title":"Int J STD AIDS"},{"issue":"9142","key":"pone.0260334.ref023","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1016\/S0140-6736(05)79824-X","article-title":"Fatal interaction between ritonavir and MDMA","volume":"352","author":"JA Henry","year":"1998","journal-title":"Lancet"},{"issue":"1","key":"pone.0260334.ref024","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1177\/135965350000500108","article-title":"Possible fatal interaction between protease inhibitors and methamphetamine","volume":"5","author":"G Hales","year":"2000","journal-title":"Antivir Ther"},{"issue":"5","key":"pone.0260334.ref025","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1097\/QAI.0000000000000776","article-title":"Intentional medication non-adherence because of interactive toxicity beliefs among HIV-positive active drug users","volume":"70","author":"SC Kalichman","year":"2015","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"4","key":"pone.0260334.ref026","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1001\/jama.2012.7961","article-title":"Antiretroviral treatment of adult HIV infection: 2012 recommendations of the International Antiviral Society-USA panel","volume":"308","author":"MA Thompson","year":"2012","journal-title":"JAMA"},{"issue":"1","key":"pone.0260334.ref027","doi-asserted-by":"crossref","first-page":"e014105","DOI":"10.1136\/bmjopen-2016-014105","article-title":"Prevalence and clinical impact of recreational drug consumption in people living with HIV on treatment: a cross-sectional study","volume":"7","author":"N Garin","year":"2017","journal-title":"BMJ Open"},{"issue":"1","key":"pone.0260334.ref028","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s12981-020-00279-y","article-title":"Drug use and antiretroviral therapy (ART) interactions: a qualitative study to explore the knowledge, beliefs, adherence, and quality of life of people living with HIV taking ART and illicit drugs","volume":"17","author":"MJ Fuster-RuizdeApodaca","year":"2020","journal-title":"AIDS Res Ther"},{"issue":"Suppl 1","key":"pone.0260334.ref029","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.1080\/09540120412331315312","article-title":"The HIV\/AIDS Treatment Adherence, Health Outcomes and Cost Study: conceptual foundations and overview","volume":"16","author":"HIV\/AIDS Treatment Adherence, Health Outcomes and Cost Study Group","year":"2004","journal-title":"AIDS Care."},{"issue":"8","key":"pone.0260334.ref030","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.2105\/AJPH.2007.113571","article-title":"The power and the promise: working with communities to analyse data, interpret findings, and get to outcomes","volume":"98","author":"SB Cashman","year":"2008","journal-title":"Am J Public Health"},{"issue":"3","key":"pone.0260334.ref031","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1177\/1524839906289376","article-title":"Using community-based participatory research to address health disparities","volume":"7","author":"NB Wallerstein","year":"2006","journal-title":"Health Promot Pract"},{"issue":"3","key":"pone.0260334.ref032","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s11606-012-2231-1","article-title":"Intentional non-adherence to medications among HIV positive alcohol drinkers: prospective study of interactive toxicity beliefs","volume":"28","author":"SC Kalichman","year":"2013","journal-title":"J Gen Intern Med"},{"key":"pone.0260334.ref033","unstructured":"Remor E. Avalia\u00e7\u00e3o on-line da ades\u00e3o ao tratamento antirretroviral para a infec\u00e7\u00e3o pelo HIV. Paper session presented at 11o. Congresso Nacional De Psicologia da Sa\u00fade. Lisboa, Portugal; 2016."},{"issue":"1","key":"pone.0260334.ref034","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1186\/s12955-019-1208-8","article-title":"Assessing quality of life in people with HIV in Spain: psychometric testing of the Spanish version of WHOQOL-HIV-BREF","volume":"17","author":"MJ Fuster-RuizdeApodaca","year":"2019","journal-title":"Health Qual Life Outcomes"},{"issue":"3","key":"pone.0260334.ref035","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1080\/09540120903111502","article-title":"Quality of life assessment in people with HIV: analysis of the WHOQOL-HIV syntax","volume":"22","author":"B Pedroso","year":"2010","journal-title":"AIDS Care"},{"issue":"20","key":"pone.0260334.ref036","first-page":"30172","article-title":"Clinical impact of recreational drug use among people living with HIV in southern Taiwan","volume":"S1684-1182","author":"GL Chen","year":"2020","journal-title":"J Microbiol Immunol Infect"},{"issue":"5","key":"pone.0260334.ref037","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1097\/QAD.0000000000000994","article-title":"Prevalence of recreational drug use is indiscriminate across antiretroviral regimens of differing drug-drug interactions among MSM","volume":"30","author":"M Daskalopoulou","year":"2016","journal-title":"AIDS"},{"issue":"3","key":"pone.0260334.ref038","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2174\/1574889809666141127101623","article-title":"Drug-drug interactions: antiretroviral drugs and recreational drugs","volume":"9","author":"O Staltari","year":"2014","journal-title":"Recent Pat CNS Drug Discov"},{"issue":"1","key":"pone.0260334.ref039","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1080\/03602532.2019.1697283","article-title":"Adverse pharmacokinetic interactions between illicit substances and clinical drugs","volume":"52","author":"KL Abbott","year":"2020","journal-title":"Drug Metab Rev"},{"key":"pone.0260334.ref040","unstructured":"Documento de consenso de Gesida\/plan Nacional sobre el Sida respecto al tratamiento antirretroviral en adultos infectados por el virus de la inmunodeficiencia humana (Actualizaci\u00f3n enero 2019). Panel de Expertos de GeSIDA y Plan nacional sobre el Sida. Ministerio de Sanidad, Consumo y Bienestar Social."},{"key":"pone.0260334.ref041","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. Department of Health and Human Services. Available at http:\/\/www.aidsinfo.nih.gov\/ContentFiles\/AdultandAdolescentGL.pdf. Accessed [4 April 2021]."},{"issue":"9","key":"pone.0260334.ref042","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1097\/QAD.0b013e32832b4377","article-title":"Metabolic outcomes in a randomized trial of nucleoside, non-nucleoside and protease inhibitor-sparing regimens for initial HIV treatment","volume":"23","author":"RH Haubrich","year":"2009","journal-title":"AIDS"},{"issue":"1","key":"pone.0260334.ref043","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/QAI.0b013e3181da1287","article-title":"Raltegravir versus Efavirenz regimens in treatment-naive HIV-1-infected patients: 96-week efficacy, durability, subgroup, safety, and metabolic analyses","volume":"55","author":"JL Lennox","year":"2010","journal-title":"JAcquir Immune Defic Syndr."},{"issue":"7","key":"pone.0260334.ref044","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1086\/656363","article-title":"Efavirenz versus boosted atazanavir or zidovudine and abacavir in antiretroviral treatment-naive, HIV-infected subjects: week 48 data from the Altair study","volume":"51","author":"RL Puls","year":"2010","journal-title":"Clin Infect Dis"},{"issue":"1","key":"pone.0260334.ref045","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1016\/S2352-3018(14)70001-3","article-title":"Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study","volume":"1","author":"M Daskalopoulou","year":"2014","journal-title":"Lancet HIV"},{"key":"pone.0260334.ref046","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.drugpo.2016.09.007","article-title":"Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS).","volume":"38","author":"AJ Schmidt","year":"2016","journal-title":"Int J Drug Policy"},{"key":"pone.0260334.ref047","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1186\/s12889-019-7747-4","article-title":"Levy, I. Recreational drug and excessive alcohol use among HIV-infected men who have sex with men in Central Israel","volume":"19","author":"Z Mor","year":"2019","journal-title":"BMC Public Health"},{"issue":"8","key":"pone.0260334.ref048","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1136\/sextrans-2015-052052","article-title":"Illicit drug use in sexual settings (\u2019chemsex\u2019) and HIV\/STI transmission risk behaviour among gay men in South London: findings from a qualitative study","volume":"91","author":"A Bourne","year":"2015","journal-title":"Sex Transm Infect"},{"key":"pone.0260334.ref049","first-page":"690","article-title":"Recreational drug use among individuals living with HIV in Europe: review of the prevalence, comparison with the general population and HIV guidelines recommendations","volume":"6","author":"N Garin","year":"2015","journal-title":"Front Microbiol"},{"key":"pone.0260334.ref050","doi-asserted-by":"crossref","first-page":"8046","DOI":"10.1038\/s41598-018-26413-5","article-title":"Prevalence and associations of illicit drug and polydrug use in people living with HIV in Vienna","volume":"8","author":"I Grabovac","year":"2018","journal-title":"Sci Rep"},{"issue":"2","key":"pone.0260334.ref051","doi-asserted-by":"crossref","first-page":"e25449","DOI":"10.1002\/jia2.25449","article-title":"The challenge of HIV treatment in an era of polypharmacy","volume":"23","author":"D Back","year":"2020","journal-title":"J Int AIDS Soc"},{"key":"pone.0260334.ref052","doi-asserted-by":"crossref","first-page":"2042098619880122","DOI":"10.1177\/2042098619880122","article-title":"Prescribing issues in older adults living with HIV: thinking beyond drug-drug interactions with antiretroviral drugs","volume":"10","author":"F Livio","year":"2019","journal-title":"Ther Adv Drug Saf"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260334","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,15]],"date-time":"2023-01-15T21:36:59Z","timestamp":1673818619000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260334"}},"subtitle":[],"editor":[{"given":"Carlo","family":"Torti","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,11,19]]},"references-count":52,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0260334","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,19]]}}}