Increase in sexual risk behavior associated with immunologic response to highly active antiretroviral therapy among HIV-infected injection drag users

Waimar Tun, Stephen J. Gange, David Vlahov, Steffanie A. Strathdee, David D. Celentano

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1167-1174
Number of pages8
JournalClinical Infectious Diseases
Volume38
Issue number8
DOIs
StatePublished - Apr 15 2004

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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