Meth, Crack, Coke and Ecstasy: Effects on HIV Disease Progression

Meth, Crack, Coke and Ecstasy: Effects on HIV Disease Progression

Stimulant use (e.g., methamphetamines) may have less of a negative effect on health outcomes for people living with HIV than previously thought. A team of researchers, in an article published in JAIDS, reported that they found no association between any frequency of stimulant use and mortality, and only a modest association between high-frequency stimulant use and the combined outcomes of mortality and progression to AIDS.

Over 1,000 HIV-positive men who have sex with men participating in the Multicenter AIDS Cohort Study (MACS) provided information for the study about methamphetamine, cocaine, crack cocaine, or ecstasy use. In addition, MACS researchers collected participant data of AIDS-defining illnesses, CD4 cell counts, viral loads, and mortality. On average, participants stayed in the study for about eight and a half years, during which time they completed study visits every three months.

The researchers analyzed participant data to look at the relationship between frequency of stimulant use and the likelihood of progressing to AIDS or dying, while controlling for outside influences such as hepatitis C co-infection, high blood pressure, high cholesterol, depression, drinking, and smoking.

"We thought there would be this dose response relationship where people who had used more often, or reported use more frequently, would have more negative health outcomes. They would die faster, or they would progress to AIDS or die faster," explains Adam Carrico, PhD, of Department of Community Health Systems, School of Nursing, University of California, San Francisco, and lead author of the paper.

Unexpectedly, they didn’t find a significant association between stimulant use over time and mortality.

"We found that when people are on HAART [highly active antiretroviral therapy], there are not mortality differences between stimulant users and non-users. Being a drug user didn’t mean that you died faster," says Carrico.

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