Self-reported Antiretroviral Therapy in Injection Drug Users

摘要: Context.—The US Public Health Service and the International AIDS Society–USA recently published recommendations for antiretroviral therapy (ART) persons infected with human immunodeficiency virus (HIV); however, anecdotal evidence suggests that HIV-infected injection drug users (IDUs) may not be receiving optimal care as defined by recommendations.Objective.—To assess ART use in IDUs.Design.—A cross-sectional survey of self-reported between July 1996 and June 1997 IDUs.Setting.—A community-based clinic affiliated Johns Hopkins University, Baltimore, Md.Participants.—A total 404 IDUs CD4+ cell counts less than 0.50×109/L recruited into a longitudinal study 1988 and 1989.Main Outcome Measure.—Self-reported was assessed: no current therapy, monotherapy, or combination or without protease inhibitor.Results.—One half (199/404 [49%]) patients reported recent ART. A total of 14% (58/404) had monotherapy, 23% (90/404) were receiving therapy without inhibitor, (57/404) triple-combination therapy with inhibitor. multivariate analysis factors associated with ART showed continuity HIV-related outpatient visit (odds ratio [OR], 4.30; 95% confidence interval [CI], 2.36-7.81 OR, 2.84; 95% CI, 1.66-4.88, respectively), count less than 0.20×109 (OR, 2.41; CI, 1.51-3.84), being drug treatment 2.16; 1.34-3.47; 2.12; 1.23-3.66, respectively), and unemployment 2.31; 1.21-4.40) reporting ART use. In other analysis, likely to receive inhibitors were current injectors 0.5; 0.3-1.0) those recently incarcerated (OR, 0.2; 0.03-0.9), but acquired syndrome were more 2.0; 0.9-4.6). Protease inhibitor doubled (P<.01) from July and December 1996 January (7.7% 14.8%, respectively).Conclusions.—Those infected HIV who tended be active clinical disease have contact health care providers. Although we do information on judgment regarding treatment decisions whether persons prescribed taken, the proportion subjects reporting suggests strategies for improving treatment this population are indicated. Expanding simultaneous treatment services infection substance abuse would enhance the response these related epidemics.