Correlates of antiretroviral utilization among hospitalized HIV-infected crack cocaine users

Rupali Kotwal Doshi, Nicholas S. Vogenthaler, Sarah Lewis, Allan Rodriguez, Lisa Metsch, Carlos Del Rio

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Despite the availability of antiretroviral therapy (ART), HIV-infected drug users, particularly crack cocaine users, continue to have high HIV-related morbidity and mortality. We conducted a cross-sectional analysis of the baseline data for hospitalized HIV-infected crack cocaine users recruited for Project HOPE (Hospital Visit Is an Opportunity for Prevention and Engagement with HIV-Positive Crack Users) in Atlanta and Miami who were eligible for ART (reported any lifetime use of ART or CD4 <350 cells/μl). Among 350 eligible participants, whose mean age was 44.9 years (SD 7.0), 49% were male, 90% were black, and 81% were heterosexual. The median CD4 count was 144 cells/μl, and 78 of 350 (22%) were taking ART. We conducted a multivariable logistic regression to examine individual, interpersonal, and structural factors as potential correlates of ART use. Reporting ≥2 visits to outpatient HIV care in the past 6 months (AOR 7.55, 95% CI 3.80-14.99), drug or alcohol treatment in the past 6 months (AOR 2.29, 95% CI 1.06-4.94), and study site being Miami (AOR 2.99, 95% CI 1.56-5.73) were associated with ART use. Current homelessness (AOR 0.41, 95% CI 0.20-0.84) and CD4 <200 cells/μl (AOR 0.29, 95% CI 0.15-0.55) were negatively associated with ART use. Among those taking ART, 60% had an HIV-1 viral load <400 copies/ml; this represented 9% of the eligible population. For HIV-infected crack cocaine users, structural factors may be as important as individual and interpersonal factors in facilitating ART utilization. Few HIV + crack cocaine users had viral suppression, but among those on ART, viral suppression was achievable.

Original languageEnglish (US)
Pages (from-to)807-814
Number of pages8
JournalAIDS research and human retroviruses
Volume28
Issue number9
DOIs
StatePublished - Sep 1 2012

ASJC Scopus subject areas

  • Immunology
  • Virology
  • Infectious Diseases

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