Svilen Konov, HIV i-Base

This study analysed the trends of antiretroviral therapy (ART) uptake among HIV-positive current drug users seeking substance abuse treatment in the HAART era at three hospitals in Barcelona, Spain, between 1997 and 2007. The results were divided into 3 periods (p) p1: 1997-1999; p2: 2000-2003; p3: 2004-2007), reflecting the evolution of HAART regimens over time.

In this analysis, 705 HIV-positive people were eligible (74.6% men); 299 were admitted in p1, 249 in p2 and 157 in p3. Mean age was 34 years, 94.7% had previous injection drug use (IDU) and 67.7% were current IDUs at admission. CD4 cell count was 399 cells/mm3 [IQR 203-632]. Lifetime prevalence of ART use was 59.4% (416/705), increasing from 48.1% in p1, to 64.6% in p2 and 72.6% in p3 (p<0.05). The prevalence of ART uptake at admission was 40.7%, increasing from 31.4% (p1) to 41.0% (p2) and 58.0% (p3) (p<0.05).

In multivariate logistic regression analysis, age, calendar period, and non-IDU were predictors of being in ART at admission. Among those taking ART, 21.6% were on suboptimal combinations, mostly during the first period. Overall, 44.6% of patients were on PI + NRTI-based regimens, 21.9% on NRTI + NNRTI-based regimens and 9.4% on triple NRTI-based regimens.

The researchers concluded that HAART uptake is steadily increasing in ongoing HIV-positive drug users. The continued “However, a remarkable percentage still remains ART-naïve despite immunosuppression. Interventions focused on the integration of both substance abuse and HIV/Aids treatment are necessary to increase survival in this population’.

Ref: Vallecillo G. et al. Increasing uptake of HAART in HIV + ongoing drug abusers. PE20.3/2