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Relationship between Non-injection Drug Use
Behaviors on Progression to AIDS and Death in a Cohort of HIV Positive
Women in the HAART Era
The aim of this study was to evaluate the effects of longitudinal
patterns and types of non-injection drug use (NIDU) on HIV progression in the HAART era. The Women's Interagency
HIV Study (WIHS), a prospective cohort study, was conducted at six
US sites.
Data
were collected semi-annually from 1994 to 2002 on 1046 HIV(+) women. Multivariate Cox proportional hazards modeling
was used to estimate relative hazards for developing AIDS and for
death
by pattern and type of NIDU.
Results
·
During
follow-up, 285 AIDS events and 287 deaths, of which 177 were AIDS-related,
were reported.
·
At baseline,
consistent and former NIDU was associated with CD4(+) counts of
< 200 cells/microl (43% and 46%, respectively) and viral load
> 40 000 copies/ml (53% and 55%, respectively).
·
Consistent
NIDU reported less HAART use (53%) compared with other NIDU patterns.
Stimulant use was associated with CD4(+) cell counts of < 200
cells/microl (53%) and lower HAART initiation (63%) compared with
other NIDU types.
·
In multivariate
analyses, progression to AIDS was significantly higher among consistent
(RH = 2.52), inconsistent (RH = 1.63) and former (RH = 1.56) users
compared with never users; and for stimulant (RH = 2.04) and polydrug
(RH = 1.65) users compared with non-users. Progression to all-cause
death was higher only among former users (RH = 1.48) compared with
never users in multivariate analysis.
·
NIDU behaviors
were not associated with progression to AIDS-related death.
In
conclusion, the authors write, “In this study, pattern and type
of NIDU were associated with HIV progression to
AIDS and all-cause mortality.
These differences were associated with lower HAART utilization among
consistent NIDU and use of stimulants, and poor baseline immunological
and virological status among former users.”
Center for Urban Epidemiologic Studies, New
York Academy of Medicine, New York, USA.
06/22/05
Reference
F Kapadia and others. The relationship between
non-injection drug use behaviors on progression to AIDS and death
in a cohort of HIV seropositive women in the era of highly active
antiretroviral therapy use. Addiction 100(7):990-1002. July 2005.
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