Combination drug therapy effectively reduces 90 percent of HIV deaths in African-American injection drug users when they are given ample access to care, according to a new Academy study in the June issue of the American Journal of Epidemiology.
Because this disadvantaged population has historically lacked access to pricey multi-drug therapy, there has long been uncertainty about whether it would reduce their late-stage HIV infection and whether these patients could adhere to such a complex treatment regimen.
The results of this important longitudinal study, conducted over the course of 14 years, show that HIV-related deaths nearly disappeared among these minority drug-users when they received access to highly active antiretroviral therapy, or HAART.
“There has been longstanding concern among clinicians and policymakers that some populations may not be good candidates to receive these life-sparing medications,” said lead author David Vlahov, PhD, director of the New York Academy Center for Urban Epidemiologic Studies, and Adjunct Professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore. That concern has been based on anticipation that persons with unstable or marginally stable lifestyles would be less able to adhere to the complex regimens, he said.
“Although medication adherence was not assessed in this study, the dramatic improvement in survival among those on HAART indicates that minority injection drug users are able to follow the drug therapy with success,” Vlahov said. “Access to these drugs should be broadened aggressively both in the U.S. and in developing countries.”