Bipolar medication use and adherence to antiretroviral therapy among patients with HIV-AIDS and bipolar disorder

James Walkup, Ayse Akincigil, Sujoy Chakravarty, Mark Olfson, Scott Bilder, Shahla Amin, Michele J. Siegel, Stephen Crystal

Publication Date: 01/01/2011

Objective: The study examined relationships between adherence to bipolar medication and to antiretroviral therapy, measured by medication fills, among patients with diagnoses of bipolar disorder and HIV infection. Methods: A retrospective study was conducted of Medicaid claims data (2001-2004) from eight states, focusing on antiretroviral adherence. The unit of analysis was person-month (N=53,971). The average observation period for the 1,687 patients was 32 months. Analyses controlled for several patient characteristics. Results: Patients possessed antiretroviral drugs in 72% of the personmonths. When a bipolar medication prescription was filled in the prior month, the rate of antiretroviral possession in the subsequent month was 78%, compared with 65% when bipolar medication was not filled in the prior month (p<.001). Odds of antiretroviral possession were 66% higher in months when patients had a prior-month supply of bipolar medication. Conclusions: Bipolar medication adherence may improve antiretroviral adherence among patients with bipolar disorder and HIV infection.