Poor adherence to HIV monitoring and treatment guidelines for HIV-infected injection drug users.
HIV Med
; 9(7): 503-7, 2008 Aug.
Article
en En
| MEDLINE
| ID: mdl-18484977
ABSTRACT
OBJECTIVES:
There is growing concern about access to HIV/AIDS care among injection drug users (IDUs). We examined rates of CD4 cell count monitoring and correlates among HIV-infected IDUs.METHODS:
This prospective observational cohort study of 460 community-recruited HIV-infected IDUs was situated in a Canadian city where all medical care is provided free of charge. Over a median follow-up period of 76 months, we evaluated factors associated with CD4 cell count monitoring through a linkage with a centralized CD4 registry.RESULTS:
Overall, <5% of IDUs had CD4 monitoring consistent with local therapeutic guidelines. In multivariate analyses, after adjustment for being on antiretroviral therapy [odds ratio (OR) 2.21, 95% confidence interval (CI) 1.84-2.70, P<0.001] female gender (OR 0.71, 95% CI 0.57-0.89, P=0.003), non-White ethnicity (OR 0.75, 95% CI 0.60-0.94, P=0.014), use of methadone maintenance therapy (OR 1.66, 95% CI 1.42-1.94, P<0.001) and daily heroin use (OR 0.72, 95% CI 0.61-0.85, P<0.001) were independently associated with CD4 monitoring.CONCLUSIONS:
Strategies to improve CD4 surveillance among IDUs are critically important, particularly for female and non-White IDUs. Expanded treatment for heroin dependence appears to have the greatest potential for improved care.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Infecciones por VIH
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Abuso de Sustancias por Vía Intravenosa
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Fármacos Anti-VIH
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Terapia Antirretroviral Altamente Activa
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Cumplimiento de la Medicación
Tipo de estudio:
Etiology_studies
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Guideline
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Qualitative_research
/
Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
País como asunto:
America do norte
Idioma:
En
Año:
2008
Tipo del documento:
Article