From the Cook County HIV Center, Division of Infectious Disease, Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Ill.
The intertwined epidemics of human immunodeficiency virus (HIV) infection
and chemical dependency continue to be a challenge for optimal medical care
delivery in the era of potent antiretroviral therapy. In this issue of JAMA,
Celentano et al1 report a cross-sectional survey
in 404 injecting drug users (IDUs) with HIV infection in Baltimore, Md, from
mid-1996 to mid-1997 in which only 57 (14%) of 404 patients reported receiving
potent antiretroviral therapy. Sixty-three percent of patients reported receiving
no (49%) or inadequate (14%) therapy. Active injecting drug use, lack of advanced
disease (acquired immunodeficiency syndrome [AIDS]), not being in a substance
abuse treatment program, and not having a usual source of primary care or
health insurance were associated with not receiving therapy.
Sherer R. Adherence and Antiretroviral Therapy in Injection Drug Users. JAMA. 1998;280(6):567-568. doi:10.1001/jama.280.6.567