Background
Clinical trial data provide uneqivocal evidence for the therapeutic benefits of combination antiretroviral therapies. There is good reason to suspect that the efficacy demonstrated in clinical trials may not be fully replicated in normal clinical settings, because of difficulties in adherence to complex medical regimens. This study assesses the impact of antiretroviral medications on mortality experience for a broadly representative cohort of people living with HIV in New York City.
Methods.
Data for this presentation come from the CHAIN Project. The original study (N=700) was conducted during 1994 and 1995. Four follow-up interviews have been conducted between six months and a year. The interviews collect a rich body of self reported data on demographic characteristics, use of health and human services, medications and health data. Mortality data are obtained through routine tracking of participants and death certificate searches. Logistic regression analysis was performed to estimate the association of use of antiretroviral medications and other factors on mortality between each successive interview.
Findings
There has been a sharp decline in mortality rates since the third interview, which coincides with the introduction of combination therapy. Use of antiretroviral therapy is associated with a substantial decline in the odds of dying during the study period (.50 adjusted odds ratio p<.01) (.28 adjusted odds ratio for HAART, p<.01). Subgroup analysis found that the beneficial effects of antiretroviral therapy extended to active substance abusers, minorities and those with low mental health functioning.
Learning Objectives: At the conclusion of this presentation, the participants will be able to describe (1) the effects of different forms of medical interventions on reduced mortality rate and (2) differential effectiveness of combination therapy for various vulnerable populations
Keywords: HIV Interventions, Mortality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.