Delay in the Initiation of HAART, Poorer Virological Response, and Higher Mortality among HIV-Infected Injecting Drug Users in Spain

Abstract

ABSTRACT

Substance use and HIV disease progression in the HAART era: Implications for the primary prevention of HIV

“…For studies published on or after 1996, the methods section was inspected to determine whether follow-up extended into the HAART era. Although 22 studies that met these criteria were identified, only 20 were determined to be eligible for inclusion in the review (Anastos et al, 2005;Baum et al, 2009;Cook et al, 2008;Egger et al, 2002;Grigoryan et al, 2009;Junghans et al, 1999;Kapadia et al, 2005a;Lucas et al, 2002Lucas et al, , 2006Malta et al, 2009;Mayer et al, 2003;Mocroft et al, 1999;Moore et al, 2004;Perez-Hoyos et al, 2003;Porter et al, 2003;Poundstone et al, 2001;Rodriguez-Arenas et al, 2006;Thorpe et al, 2004;Wood et al, 2003;Wood et al, 2008). Due to substantial overlap in the primary outcome examined in four studies from the two cohorts (Grigoryan et al, 2009;Hall et al, 2006;Palepu et al, 2003;Wood et al, 2003), only one study from each cohort was selected for the present review (Grigoryan et al, 2009;Wood et al, 2003).…”

“…when compared to MSM(Egger et al, 2002). Using data from 4643 participants enrolled in the Spanish AIDS Research Network cohort (CoRIS-MD),Rodriguez-Arenas et al (2006) observed that IDU initiated HAART later (HR = 0.67; 95% CI = 0.57-0.79), were less likely to achieve virologic suppression after starting HAART (HR = 0.86; 95% CI = 0.74-0.99), and displayed more than a two-fold faster AIDS-related mortality rate (HR = 2.51; 95% CI = 1.03-6.10) compared to MSM. In addition to impaired HAART utilization and greater HAART non-adherence, late presentation for HIV medical care could also account for the effect of IDU on hastened HIV disease progression.…”

Increased mortality among Indigenous persons in a multisite cohort of people living with HIV in Canada

“…23,24 Higher mortality rates were reportedly due to lower ARV uptake and were attributed to ADIs. 24 In other studies, IDUs had similar responses to ARVs as non-IDUs and increased mortality was associated with non-HIV-related causes such as suicide, chronic liver disease and drug overdoses. 23 Suboptimal adherence has been associated with injection behaviours among current IDUs and social instability among former IDUs.…”

Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013

“…Previous studies have identified several factors as potentially contributing to late presentation, poor HAART uptake and low retention in HIV care. These factors include stigma, fear of status disclosure, complexity of treatment regimens and lack of psychosocial support (48); lack of confidentiality and fear of discrimination at health facilities, workplace and community (49); poor staff-patient relationships and underestimation of the need for HAART (50); and active drug use (43,46). Stigma and fear of disclosure are particularly important among females living in a conservative society.…”