Time to initiating highly active antiretroviral therapy among HIV-infected injection drug users

David D Celentano, Noya Galai, Ajay K. Sethi, Nina G. Shah, Steffanie A. Strathdee, David Vlahov, Joel E. Gallant

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1707-1715
Number of pages9
JournalAIDS
Volume15
Issue number13
DOIs
StatePublished - Sep 7 2001

Fingerprint

Highly Active Antiretroviral Therapy
Drug Users
HIV
Injections
Therapeutics
CD4 Lymphocyte Count
Patient Acceptance of Health Care
Men's Health
Baltimore
Methadone
Health Insurance
Cohort Studies
Outcome Assessment (Health Care)
Guidelines
Drug Therapy

Keywords

  • Health care access
  • Highly active antiretroviral therapy
  • Injection drug users

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Time to initiating highly active antiretroviral therapy among HIV-infected injection drug users. / Celentano, David D; Galai, Noya; Sethi, Ajay K.; Shah, Nina G.; Strathdee, Steffanie A.; Vlahov, David; Gallant, Joel E.

In: AIDS, Vol. 15, No. 13, 07.09.2001, p. 1707-1715.

Research output: Contribution to journalArticle

Celentano, David D ; Galai, Noya ; Sethi, Ajay K. ; Shah, Nina G. ; Strathdee, Steffanie A. ; Vlahov, David ; Gallant, Joel E. / Time to initiating highly active antiretroviral therapy among HIV-infected injection drug users. In: AIDS. 2001 ; Vol. 15, No. 13. pp. 1707-1715.
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abstract = "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.",
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