TY - JOUR
T1 - Increase in sexual risk behavior associated with immunologic response to highly active antiretroviral therapy among HIV-infected injection drag users
AU - Tun, Waimar
AU - Gange, Stephen J.
AU - Vlahov, David
AU - Strathdee, Steffanie A.
AU - Celentano, David D.
N1 - Funding Information:
Financial support: This research was supported in part by the National Institute on Drug Abuse (grants DA04334 and DA12568) and in part by a National Research Service Award (no. 1-F31-MH12660) from the National Institute of Mental Hygiene to (W.T.).
PY - 2004/4/15
Y1 - 2004/4/15
N2 - This study identifies factors associated with high-risk sexual and drug injection behaviors among human immunodeficiency virus (HIV)-infected injection drug users (IDUs) after initiation of highly active antiretroviral therapy (HAART). Participants of a large cohort study of IDUs in Baltimore were seen at semiannual visits; blood samples to determine HIV serostatus and CD4+ cell count were obtained, as well as questionnaire data on risk behaviors and medication. Survival analysis conducted for 190 HIV-infected participants who initiated HAART during 1996-2000 revealed that an increase in CD4+ cell count (categorized as an increase of >0 cells/mm3 or of ≤0 cells/mm3) after HAART initiation was independently associated with engaging in any sexual intercourse (adjusted relative hazard [ARH], 1.83; 95% CI, 1.22-2.73) and with a 3-fold increase in the hazard of engaging in unprotected sexual intercourse (ARH, 3.29; 95% CI, 1.57-6.93) after HAART initiation. An increase in CD4+ cell count after HAART initiation was not associated with injection of drugs or needle sharing. Risk reduction counseling remains important, despite improvements in the treatment of HIV infection.
AB - This study identifies factors associated with high-risk sexual and drug injection behaviors among human immunodeficiency virus (HIV)-infected injection drug users (IDUs) after initiation of highly active antiretroviral therapy (HAART). Participants of a large cohort study of IDUs in Baltimore were seen at semiannual visits; blood samples to determine HIV serostatus and CD4+ cell count were obtained, as well as questionnaire data on risk behaviors and medication. Survival analysis conducted for 190 HIV-infected participants who initiated HAART during 1996-2000 revealed that an increase in CD4+ cell count (categorized as an increase of >0 cells/mm3 or of ≤0 cells/mm3) after HAART initiation was independently associated with engaging in any sexual intercourse (adjusted relative hazard [ARH], 1.83; 95% CI, 1.22-2.73) and with a 3-fold increase in the hazard of engaging in unprotected sexual intercourse (ARH, 3.29; 95% CI, 1.57-6.93) after HAART initiation. An increase in CD4+ cell count after HAART initiation was not associated with injection of drugs or needle sharing. Risk reduction counseling remains important, despite improvements in the treatment of HIV infection.
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U2 - 10.1086/383033
DO - 10.1086/383033
M3 - Article
C2 - 15095224
AN - SCOPUS:2342573049
SN - 1058-4838
VL - 38
SP - 1167
EP - 1174
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 8
ER -