TY - JOUR
T1 - Time to initiating highly active antiretroviral therapy among HIV-infected injection drug users
AU - Celentano, David D.
AU - Galai, Noya
AU - Sethi, Ajay K.
AU - Shah, Nina G.
AU - Strathdee, Steffanie A.
AU - Vlahov, David
AU - Gallant, Joel E.
PY - 2001/9/7
Y1 - 2001/9/7
N2 - Objective: Studies have shown that HIV-infected injection drug users (IDUs) are less likely to receive antiretroviral therapy than non-drug users. We assess factors associated with initiating highly active antiretroviral therapy (HAART) in HIV-infected IDUs. Methods: A cohort study of IDUs carried out between 1 January 1996 and 30 June 1999 at a community-based study clinic affiliated to the Johns Hopkins University, Baltimore, Maryland. The participants were a total of 528 HIV-infected IDUs eligible for HAART based on CD4+ cell count. The main outcome measure was the time from treatment eligibility to first self-reported HAART use, as defined by the International AIDS Society-USA panel (IAS-USA) guidelines. Results: By 30 June 1999, 58.5% of participants had initiated HAART, most of whom switched from mono- or dual-combination therapy to a HAART regimen. Nearly one-third of treatment-eligible IDUs never received antiretroviral therapy. Cox proportional hazards regression showed that initiating HAART was independently associated with not injecting drugs, methadone treatment among men, having health insurance and a regular source of care, lower CD4+ cell count and a history of antiretroviral therapy. Conclusions: Self-reposed initiation of HAART is steadily increasing among IDUs who are eligible for treatment; however, a large proportion continues to use nonHAART regimens and many remain treatment-naive. Although both groups appear to have lower health care access and utilization, IDUs without a history of antiretroviral therapy use would have more treatment options available to them once they become engaged in HIV care.
AB - Objective: Studies have shown that HIV-infected injection drug users (IDUs) are less likely to receive antiretroviral therapy than non-drug users. We assess factors associated with initiating highly active antiretroviral therapy (HAART) in HIV-infected IDUs. Methods: A cohort study of IDUs carried out between 1 January 1996 and 30 June 1999 at a community-based study clinic affiliated to the Johns Hopkins University, Baltimore, Maryland. The participants were a total of 528 HIV-infected IDUs eligible for HAART based on CD4+ cell count. The main outcome measure was the time from treatment eligibility to first self-reported HAART use, as defined by the International AIDS Society-USA panel (IAS-USA) guidelines. Results: By 30 June 1999, 58.5% of participants had initiated HAART, most of whom switched from mono- or dual-combination therapy to a HAART regimen. Nearly one-third of treatment-eligible IDUs never received antiretroviral therapy. Cox proportional hazards regression showed that initiating HAART was independently associated with not injecting drugs, methadone treatment among men, having health insurance and a regular source of care, lower CD4+ cell count and a history of antiretroviral therapy. Conclusions: Self-reposed initiation of HAART is steadily increasing among IDUs who are eligible for treatment; however, a large proportion continues to use nonHAART regimens and many remain treatment-naive. Although both groups appear to have lower health care access and utilization, IDUs without a history of antiretroviral therapy use would have more treatment options available to them once they become engaged in HIV care.
KW - Health care access
KW - Highly active antiretroviral therapy
KW - Injection drug users
UR - http://www.scopus.com/inward/record.url?scp=0035823013&partnerID=8YFLogxK
U2 - 10.1097/00002030-200109070-00015
DO - 10.1097/00002030-200109070-00015
M3 - Article
C2 - 11546947
AN - SCOPUS:0035823013
SN - 0269-9370
VL - 15
SP - 1707
EP - 1715
JO - AIDS
JF - AIDS
IS - 13
ER -