Barriers to Use of Free Antiretroviral Therapy in Injection Drug Users
Dados Bibliográficos
| ID | 23367679 |
|---|---|
| Autores | Steffanie A Strathdee (0000-0002-7724-691X, St. Paul's Hospital, autor correspondente) |
| Ano | 1998 |
| Volume | 280 |
| Fascículo | 6 |
| Páginas | 547 |
| Data de publicação | 1998-08-12 |
| Peer Reviewed | Sim |
| Open Access | Não |
| Tipo | ARTICLE |
| Periódico | JAMA (JOURNAL) |
| Identificadores do periódico | ISSN: 0098-7484 • E-ISSN: 1538-3598 |
| Editora | American Medical Association (AMA) (PUBLISHER) |
| DOI | 10.1001/jama.280.6.547 |
| PMID | 9707146 |
| OpenAlex | W2021847155 |
| Idioma | EN |
| Citações recebidas | 112 |
| Referências citadas | 3 |
CONTEXT: In British Columbia, human immunodeficiency virus (HIV)-infected persons eligible for antiretroviral therapy may receive it free but the extent to which HIV-infected injection drug users access it is unknown. OBJECTIVE: To identify patient and physician characteristics associated with antiretroviral therapy utilization in HIV-infected injection drug users. DESIGN: Prospective cohort study with record linkage between survey data and data from a provincial HIV/AIDS (acquired immunodeficiency syndrome) drug treatment program. SETTING: British Columbia, where antiretroviral therapies are offered free to all persons with HIV infection with CD4 cell counts less than 0.50 x 10(9)/L (500/microL) and/or HIV-1 RNA levels higher than 5000 copies/mL. SUBJECTS: A total of 177 HIV-infected injection drug users eligible for antiretroviral therapy, recruited through the prospective cohort study since May 1996. MAIN OUTCOME MEASURES: Patient use of antiretroviral drugs through the provincial drug treatment program and physician experience treating HIV infection. RESULTS: After a median of 11 months after first eligibility, only 71 (40%) of 177 patients had received any antiretroviral drugs, primarily double combinations (47/71 [66%]). Both patient and physician characteristics were associated with use of antiretroviral drugs. After adjusting for CD4 cell count and HIV-1 RNA level at eligibility, odds of not receiving antiretrovirals were increased more than 2-fold for females (odds ratio [OR], 2.53; 95% confidence interval [CI], 1.08-5.93) and 3-fold for those not currently enrolled in drug or alcohol treatment programs (OR, 3.49; 95% CI, 1.45-8.40). Younger drug users were less likely to receive therapy (OR, 0.47/10-y increase; 95% CI, 0.28-0.80). Those with physicians having the least experience treating persons with HIV infection were more than 5 times less likely to receive therapy (OR, 5.55; 95% CI, 2.49-12.37). CONCLUSIONS: Despite free antiretroviral therapy, many HIV-infected injection drug users are not receiving it. Public health efforts should target younger and female drug users, and physicians with less experience treating HIV infection.
Antiretroviral therapy · Cohort · Cohort study · Confidence interval · Drug · Human immunodeficiency virus (HIV) · Odds ratio · Prospective cohort study · Viral load · HIV, Drug Use, Sexual Risk · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions · Immunology · Internal Medicine · Medicine · Pharmacology
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Shifts in substance use patterns among a cohort of people who use opioids after delisting of OxyContin in BC, Canada
Association of sex work and social-structural factors with non-fatal overdose among women who use drugs in Vancouver, Canada
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Elevated rates of antiretroviral treatment discontinuation among HIV-infected injection drug users
Unintended impacts of regulatory changes to British Columbia Methadone Maintenance Program on addiction and HIV-related outcomes
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Employment predicts decreased mortality among HIV-seropositive illicit drug users in a setting of universal HIV care
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| Obras citantes distintas | 112 |
|---|---|
| Citações por ano | 4,15 |
| Intervalo de citações | 1999 - 2026 (28) |
| Velocidade de citação | current |
| Altamente citado | Sim |
| Tipos de citação | Neutras: 110 |