The 130th Annual Meeting of APHA

Abstract #47543

Sharon Lu, MPH, Amy R. Wohl, MPH, PhD, Jane Turner, MS, and Gordon Bunch, MA. HIV Epidemiology Program, Department of Health Services, Los Angeles County, 600 S. Commonwealth Ave., Suite 1920, Los Angeles, CA 90005, (213)351-8154, slu@dhs.co.la.ca.us

Objective: To compare OI incidence in HIV-infected women with a history of substance abuse to those without in the pre- and post-HAART era and to compare PCP and MAC treatment failure in the two groups.Methods: Study subjects included 1,039 HIV-infected women receiving care at four clinics participating in the Adult/Adolescent Spectrum of Disease Project from 1990 to 2000, a national longitudinal medical record review study of HIV-infected patients. We compared pre- and post-HAART OI incidence between substance-abusing women and non-substance abusing women. We also compared treatment failure rates for PCP and MAC prophylaxis in the two groups.Results: Comparing the pre-and post-HAART periods (1993-1996 vs. 1997-2000), women without a history of substance abuse had a sharper decrease in the combined AIDS-defining OI incidence than women with a history of substance abuse (-80% vs. -41% respectively). Women without a history of substance abuse also had sharper decreases in the incidence of the three major AIDS-defining OIs. The specific OIs are PCP (-71% vs. -58%), wasting syndrome (-81% vs. –60%) and esophageal candidiasis (-65% vs. +49%). Among women who were eligible and prescribed PCP prophylaxis, 24% of the substance abusing women developed PCP later compared to 16% of the non-substance abusing women (OR: 1.7, 95%CI: 1.1-2.8).Conclusion: Though we see a sharp decrease in OI incidence in the HAART era, women with a history of substance abuse did not benefit to the same extent as women without a history of substance abuse. This may be due to poor adherence with HAART or prophylaxis.

Learning Objectives:

• To compare OI incidence in HIV-infected women with a history of substance abuse to those without in the pre- and post-HAART era and to compare PCP and MAC treatment failure rates in the two groups.

Keywords: HIV/AIDS, Substance Abuse

Presenting author's disclosure statement:
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.