Wood Evan, Kerr Thomas, Hogg Robert S, Palepu Anita, Zhang Ruth, Strathdee Steffanie A, Montaner Julio S G
British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Canada.
Drug Alcohol Rev. 2006 Sep;25(5):451-4. doi: 10.1080/09595230600883313.
Improving access to antiretroviral therapy among injection drug users remains an urgent public health concern. We examined the time to antiretroviral therapy (ART) use among antiretroviral naive HIV-infected injection drug users who were unaware of their HIV status to examine the impact of receipt of HIV test results on uptake of ART. Time to ART use was examined using Kaplan - Meier methods, and factors associated with the time to ART were evaluated using Cox proportional hazards regression. Between May 1996 and May 2003, 312 HIV-infected individuals were enrolled into the Barriers to Antiretroviral Therapy (BART) cohort, among whom 105 (33.7%) reported not knowing their HIV status at baseline. At 24 months post-baseline, those participants who returned for test results within 8 months initiated ART at a significantly elevated rate [adjusted relative hazard = 1.87 (95% CI: 1.05 - 3.33)]. These findings demonstrate the potential to improve uptake of ART among injection drug users through targeted HIV testing and counselling initiatives that encourage the receipt of HIV test results, and suggest that strategies to improve awareness of HIV infection may improve access to antiretroviral therapy.
提高注射吸毒者获得抗逆转录病毒疗法的机会仍然是一个紧迫的公共卫生问题。我们研究了未意识到自己感染艾滋病毒的初治艾滋病毒感染注射吸毒者开始使用抗逆转录病毒疗法（ART）的时间，以检验获得艾滋病毒检测结果对接受ART的影响。使用Kaplan-Meier方法研究开始使用ART的时间，并使用Cox比例风险回归评估与开始使用ART时间相关的因素。1996年5月至2003年5月期间，312名艾滋病毒感染者被纳入抗逆转录病毒疗法障碍（BART）队列，其中105人（33.7%）报告在基线时不知道自己的艾滋病毒感染状况。在基线后24个月时，那些在8个月内回来获取检测结果的参与者开始接受ART的比例显著升高[调整后的相对风险=1.87（95%CI：1.05-3.33）]。这些发现表明，通过有针对性的艾滋病毒检测和咨询举措来鼓励接受艾滋病毒检测结果，有可能提高注射吸毒者接受ART的比例，并表明提高艾滋病毒感染知晓率的策略可能会改善获得抗逆转录病毒疗法的机会。
