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Injection Drug Use and HIV Antiretroviral Therapy Discontinuation in A Canadian Setting

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Abstract

We investigated whether drug-related behaviors predicted antiretroviral therapy (ART) discontinuation among a cohort of injection drug users (IDU) in a Canadian setting. Cox regression analyses were used to investigate the impact of drug use patterns on rates of ART discontinuation among a sample of HIV-positive IDU in Vancouver, Canada between May 1996 and April 2008. In total, 408 HIV-positive IDU initiated ART during the study period, among whom 257 (63.0%) discontinued ART at least once. Rates of ART discontinuation were not significantly elevated among those who reported ongoing injection of heroin, cocaine, or other illicit drugs in comparison to those who reported not injecting drugs. However, public drug use was significantly predictive of ART discontinuation. Our findings may contribute to a reconsideration of the role of active drug use in determining retention in ART programs among IDU.

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Acknowledgments

The authors thank the study participants for their contribution to the research, as well as current and past researchers and staff. We would specifically like to thank Deborah Graham, Peter Vann, Caitlin Johnston, Steve Kain, and Calvin Lai for their research and administrative assistance. The study was supported by the US National Institutes of Health (R01DA021525) and the Canadian Institutes of Health Research (MOP–79297). Thomas Kerr, Dan Werb and M-J Milloy are supported by the Canadian Institutes of Health Research. Thomas Kerr is supported by the Michael Smith Foundation for Health Research. Dan Werb, M-J Milloy, Thomas Kerr, Ruth Zhang, and Evan Wood have no conflicts of interest to declare. Julio Montaner has received grants from, served as an ad hoc adviser to, or spoken at events sponsored by Abbott, Argos Therapeutics, Bioject Inc., Boehringer Ingelheim, BMS, Gilead Sciences, GlaxoSmithKline, Hoffmann-La Roche, Janssen-Ortho, Merck Frosst, Panacos, Pfizer Ltd., Schering, Serono Inc., TheraTechnologies, Tibotec (J&J), and Trimeris.

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Werb, D., Milloy, MJ., Kerr, T. et al. Injection Drug Use and HIV Antiretroviral Therapy Discontinuation in A Canadian Setting. AIDS Behav 17, 68–73 (2013). https://doi.org/10.1007/s10461-012-0136-y

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