HIV Patients Who Use Stimulant Drugs Benefit from ADT

Antiretroviral therapy provides similar benefits for stimulant users and non-users alike.

HIV-infected patients who reported using stimulant drugs achieved comparable lifesaving benefits from antiretroviral therapy comparable to non-drug users with HIV, according to a recent study.

Researchers from the University of California at San Francisco found that, in a study of 341 HIV-infected males who reported using drugs like cocaine or methamphetamine at more than half of a minimum of 2 visits, had a slightly increased chance of progressing to AIDS or dying following the start of antiretroviral therapy compared with non-users at more than half of at least two study visits.

"Patients with HIV who use stimulants and other substances often experience difficulties with accessing antiretroviral therapy, partially due to the concerns of healthcare providers that they will not be able take their medications as directed,” said study primary investigator Adam W. Carrico, PhD, in a press release. “Findings from this study demonstrate that many stimulant users take their antiretroviral therapy at levels sufficient to avoid negative clinical outcomes. When we look at overall mortality, antiretroviral therapy leads to similar clinical benefits for both stimulant users and non-users, notwithstanding stimulant use.”

Published online in the Journal of Acquired Immune Deficiency Syndromes, researchers studied 1313 HIV-infected men who have sex with men through the Multicenter AIDS Cohort Study, which examines HIV infection in the United States among men who have sex with men.

"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. “Programs integrating substance abuse services with HIV clinical care may both improve health outcomes for patients and reduce new infections.”

The researchers noted the benefit for patients from a stimulant treatment outpatient program within the clinical setting to provide substance abuse and mental health treatment that is integrated with primary medical care.

"The pattern of use varies and the real issue is whether patients can take their antiretrovirals as prescribed,” said Valerie Gruber, PhD, UCSF professor of psychiatry in a press release. “We find that some patients are able to start taking antiretrovirals very reliably before they are able to decrease or stop their stimulant use, which often requires more complex behavioral, emotional, interpersonal and environmental changes. Being in an HIV primary care setting allows us to engage stimulant users even if they are not ready to go to specialty substance abuse programs or support groups.”