Medically Eligible Women Who Do Not Use HAART: The Importance of Abuse, Drug Use, and Race
September 2, 2004
The researchers investigated the prevalence and characteristics of HIV-positive women who do not report using highly active antiretroviral therapy (HAART). The investigators analyzed HAART use among 1,165 HIV-positive women enrolled in the Women's Interagency HIV Study (WIHS), a longitudinal multicenter study funded by the National Institutes of Health. Between Oct. 1, 2000 and March 31, 2001, 254 women with clinical indicators for HAART reported not using it; 635 reported HAART use; and 276 for whom HAART was not indicated reported either no therapy or mono or combination therapy.Adapted from:
The researchers performed a multivariate analysis to determine which factors predicted lack of HAART use among clinically eligible women, controlling for high school education; below-poverty-level income; health insurance; any crack, cocaine or heroin use; race; study site; age; housing status; depressive symptoms; any history of abuse; and hepatitis C infection.
They found that current crack, cocaine or heroin use, being non-white, and experience of any physical or sexual abuse increased the likelihood of no HAART use among clinically eligible women. Women who used crack, cocaine or heroin during the past year were more than twice as likely not to use HAART even when indicated, the scientists found. Women with a history of physical/sexual abuse were more than 1.5 times more likely to lack HAART when clinically eligible, according to the report, and white women were half as likely to be non-HAART users.
When queried in late 2000 and early 2001, 1 of 4 women in WIHS for whom HAART was medically indicated reported not using this therapy, the investigators wrote. Even after 5 years of continued proof of the efficacy of antiretroviral therapy, with the development of more antiretroviral agents and more convenient regimens, and greater opportunity for access to these medications, a significant number of women remained without the benefits of HAART. History of physical/sexual abuse, current drug use and non-White race were all associated with lack of HAART use.
Childhood sexual abuse prevention, more intensive abuse treatment, and continuing drug treatment may enhance HIV disease treatment of women, the authors suggested.
American Journal of Public Health
07.04; Vol. 94; No. 7: P. 1147-1151; Mardge H. Cohen, M.D.; Judith A. Cook, Ph.D.; Dennis Grey, B.A.; Mary Young, M.D.; Lawrence H. Hanau, M.D.; Phyllis Tien, M.D.; Alexandra M. Levine, M.D.; Tracey E. Wilson, M.D.
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.