Substance use and HIV disease progression in the HAART era: Implications for the primary prevention of HIV

Research output: Contribution to journalReview article

63 Citations (Scopus)

Abstract

Prior to the era of highly active anti-retroviral therapy (HAART), cohort studies provided equivocal evidence to support the hypothesis that substance use predicts more rapid HIV disease progression. The present review examined the effects of substance use on HIV disease progression in cohort studies with follow-up that continued into the HAART era. Of the 20 studies included in this review, 16 observed that substance use predicted at least one indicator of HIV disease progression. Ten of the 11 studies that followed participants exclusively in the HAART era observed an effect of substance use on HIV disease progression. Findings across studies indicate that stimulant use promotes more rapid HIV disease progression and the effects of substance use on HIV disease progression can persist after controlling for self-reported HAART non-adherence. Future investigations that examine the bio-behavioral pathways whereby substance use promotes HIV disease progression should include: measures of HIV genotypic and phenotypic resistance, multi-method assessment of adherence, and assessment of co-morbid infections that are more prevalent among substance users. Although further mechanistic research is needed, findings from existing cohort studies have clear clinical implications. Implementing screening, brief intervention and referral to substance abuse treatment in HIV medical care could optimize health outcomes and decrease HIV transmission rates by boosting the effectiveness of "Test and Treat" approaches to HIV prevention.

Original languageEnglish (US)
Pages (from-to)940-947
Number of pages8
JournalLife Sciences
Volume88
Issue number21-22
DOIs
StatePublished - May 23 2011
Externally publishedYes

Fingerprint

Primary Prevention
Disease Progression
HIV
Therapeutics
Cohort Studies
Health care
Screening
Health
Coinfection
Substance-Related Disorders
Referral and Consultation

Keywords

  • Adherence
  • Antiretroviral
  • Cocaine
  • Disease progression
  • Highly active
  • HIV/AIDS
  • Injection drug use
  • Methamphetamine
  • Mortality
  • Norepinephrine
  • Substance use
  • Survival

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Substance use and HIV disease progression in the HAART era : Implications for the primary prevention of HIV. / Carrico, Adam.

In: Life Sciences, Vol. 88, No. 21-22, 23.05.2011, p. 940-947.

Research output: Contribution to journalReview article

@article{2e13275c5303488fbf06cac34adcd8fe,
title = "Substance use and HIV disease progression in the HAART era: Implications for the primary prevention of HIV",
abstract = "Prior to the era of highly active anti-retroviral therapy (HAART), cohort studies provided equivocal evidence to support the hypothesis that substance use predicts more rapid HIV disease progression. The present review examined the effects of substance use on HIV disease progression in cohort studies with follow-up that continued into the HAART era. Of the 20 studies included in this review, 16 observed that substance use predicted at least one indicator of HIV disease progression. Ten of the 11 studies that followed participants exclusively in the HAART era observed an effect of substance use on HIV disease progression. Findings across studies indicate that stimulant use promotes more rapid HIV disease progression and the effects of substance use on HIV disease progression can persist after controlling for self-reported HAART non-adherence. Future investigations that examine the bio-behavioral pathways whereby substance use promotes HIV disease progression should include: measures of HIV genotypic and phenotypic resistance, multi-method assessment of adherence, and assessment of co-morbid infections that are more prevalent among substance users. Although further mechanistic research is needed, findings from existing cohort studies have clear clinical implications. Implementing screening, brief intervention and referral to substance abuse treatment in HIV medical care could optimize health outcomes and decrease HIV transmission rates by boosting the effectiveness of {"}Test and Treat{"} approaches to HIV prevention.",
keywords = "Adherence, Antiretroviral, Cocaine, Disease progression, Highly active, HIV/AIDS, Injection drug use, Methamphetamine, Mortality, Norepinephrine, Substance use, Survival",
author = "Adam Carrico",
year = "2011",
month = "5",
day = "23",
doi = "10.1016/j.lfs.2010.10.002",
language = "English (US)",
volume = "88",
pages = "940--947",
journal = "Life Sciences",
issn = "0024-3205",
publisher = "Elsevier Inc.",
number = "21-22",

}

TY - JOUR

T1 - Substance use and HIV disease progression in the HAART era

T2 - Implications for the primary prevention of HIV

AU - Carrico, Adam

PY - 2011/5/23

Y1 - 2011/5/23

N2 - Prior to the era of highly active anti-retroviral therapy (HAART), cohort studies provided equivocal evidence to support the hypothesis that substance use predicts more rapid HIV disease progression. The present review examined the effects of substance use on HIV disease progression in cohort studies with follow-up that continued into the HAART era. Of the 20 studies included in this review, 16 observed that substance use predicted at least one indicator of HIV disease progression. Ten of the 11 studies that followed participants exclusively in the HAART era observed an effect of substance use on HIV disease progression. Findings across studies indicate that stimulant use promotes more rapid HIV disease progression and the effects of substance use on HIV disease progression can persist after controlling for self-reported HAART non-adherence. Future investigations that examine the bio-behavioral pathways whereby substance use promotes HIV disease progression should include: measures of HIV genotypic and phenotypic resistance, multi-method assessment of adherence, and assessment of co-morbid infections that are more prevalent among substance users. Although further mechanistic research is needed, findings from existing cohort studies have clear clinical implications. Implementing screening, brief intervention and referral to substance abuse treatment in HIV medical care could optimize health outcomes and decrease HIV transmission rates by boosting the effectiveness of "Test and Treat" approaches to HIV prevention.

AB - Prior to the era of highly active anti-retroviral therapy (HAART), cohort studies provided equivocal evidence to support the hypothesis that substance use predicts more rapid HIV disease progression. The present review examined the effects of substance use on HIV disease progression in cohort studies with follow-up that continued into the HAART era. Of the 20 studies included in this review, 16 observed that substance use predicted at least one indicator of HIV disease progression. Ten of the 11 studies that followed participants exclusively in the HAART era observed an effect of substance use on HIV disease progression. Findings across studies indicate that stimulant use promotes more rapid HIV disease progression and the effects of substance use on HIV disease progression can persist after controlling for self-reported HAART non-adherence. Future investigations that examine the bio-behavioral pathways whereby substance use promotes HIV disease progression should include: measures of HIV genotypic and phenotypic resistance, multi-method assessment of adherence, and assessment of co-morbid infections that are more prevalent among substance users. Although further mechanistic research is needed, findings from existing cohort studies have clear clinical implications. Implementing screening, brief intervention and referral to substance abuse treatment in HIV medical care could optimize health outcomes and decrease HIV transmission rates by boosting the effectiveness of "Test and Treat" approaches to HIV prevention.

KW - Adherence

KW - Antiretroviral

KW - Cocaine

KW - Disease progression

KW - Highly active

KW - HIV/AIDS

KW - Injection drug use

KW - Methamphetamine

KW - Mortality

KW - Norepinephrine

KW - Substance use

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=79956195241&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79956195241&partnerID=8YFLogxK

U2 - 10.1016/j.lfs.2010.10.002

DO - 10.1016/j.lfs.2010.10.002

M3 - Review article

C2 - 20934437

AN - SCOPUS:79956195241

VL - 88

SP - 940

EP - 947

JO - Life Sciences

JF - Life Sciences

SN - 0024-3205

IS - 21-22

ER -