October 16, 2014
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ART beneficial for MSM with HIV reporting stimulant use

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Antiretroviral therapy had benefits for HIV-positive men who have sex with men reporting stimulant use compared with non-users, according to recently published data.

“Patients with HIV who use stimulants and other substances often experience difficulties with accessing ART, partially due to the concerns of health care providers that they will not be able to take their medications as directed,” Adam W. Carrico, PhD, of the University of California, San Francisco, said in a press release. “Findings from this study demonstrate that many stimulant users take their ART at levels sufficient to avoid negative clinical outcomes.”

Carrico and colleagues examined the records of MSM with HIV enrolled in the Multicenter AIDS Cohort Study (n=1313) from 1996 to 2012, some of which reported stimulant use (n=341). The cumulative proportion of study visits with reported stimulant use was compared with cases of all-cause mortality and AIDS or all-cause mortality.

Researchers found no significant association between any level of stimulant use and all-cause mortality. A competing risks analysis also indicated that no level of stimulant use was associated with increased mortality, AIDS-related or not.

“When we look at overall mortality, ART leads to similar clinical benefits for both stimulant users and non-users, notwithstanding stimulant use,” Carrico said in the release.

Of the men with HIV who did not have AIDS upon initiating ART (n=648), however, reporting stimulate use at 50% or more study visits was associated with increased odds of progression to AIDS or all-cause mortality (adjusted OR=1.54; 95% CI, 1.02-2.33).

“If we are to achieve the goals of the President’s National HIV/AIDS Strategy and UNAIDS to end the HIV/AIDS epidemic, we will need to treat HIV-positive active substance users for their HIV while encouraging them to stop or reduce their substance use,” Carrico said in the release. “Programs integrating substance abuse services with HIV clinical care may both improve health outcomes for patients and reduce new infections.”

Disclosure: The researchers report no relevant financial disclosures.