A study by researchers in New York City shows that HIV-positive gay and bisexual men in the city were more likely to miss medication doses or take their anti-HIV drugs later than usual following the September 11, 2001 terrorist attacks. Data from the ongoing study, posted on GayHealth.com, were collected from 68 men in the city before and after the attacks. The mean number of missed doses of protease inhibitors among the study subjects increased from 2.67 per week two weeks prior to the attacks to 5.07 times per week in the two weeks following the destruction of the World Trade Center. The men also reported that they were less likely to take their medications within the prescribed window period after September 11.
The anxiety, uncertainty about the future, and grief associated with the attacks played key roles in the drop in adherence rates, the researchers said.
"We found that participants repeatedly brought up how their lives have been impacted by September 11," said principle researcher Perry Halkitis. "Essentially, the factors that we already know are related to adherence, such as coping skills, self-efficacy, and complexity of the regimen, were still factors after September 11 and in fact explained whose adherence levels were most likely to decrease after September 11."
Stephen Goldstone, an Advocate.com contributor and medical director of GayHealth.com, said the psychological effects of the terrorist attacks also could have lead to increased unprotected and risky sexual behavior among gay and bisexual men. If the viral loads of HIV-positive men are rising due to noncompliance with their anti-HIV medication regimens, it's possible that they may be more able to infect their sex partners through unprotected sex. "We need to know whether the trend of missed medications was quickly corrected or if it is an ongoing phenomenon before we can better assess the impact," he said.