Trends in AIDS Mortality, Retention in Opioid Agonist Therapy, and HIV RNA Suppression in HIV-Infected People Who Injected Drugs from 2000 to 2015

AIDS Behav. 2018 Sep;22(9):2766-2772. doi: 10.1007/s10461-018-2033-5.

Abstract

AIDS is a major cause of preventable mortality in HIV-infected people who inject drugs (HIV-PWID). An observational study was conducted to examine trends in AIDS mortality and related factors among HIV-infected individuals who died between 2000 and 2015 at an urban hospital. Overall HIV-mortality was 6.5% (413/6307) with no changes over time (p 0.76). AIDS mortality dropped in HIV-PWID (p 0.02) although it represented 26.4% at the end of study period. Age (per one-year increase) [odds ratio (OR) 0.95], third study period (2010-2015) (OR 0.54), HIV-PWID on opioid agonist therapy (OAT) (OR 0.39), and HIV RNA suppression (OR 0.15) were associated with AIDS mortality. OAT was reported in 58.3% (161/276) and RNA suppression in 30.9% (85/276) of HIV-PWID. OAT non-retention was due to drop-outs [85.2% (98/115)] and rejection [14.8% (17/115)] in HIV-PWID. Therefore, additional strategies are required to improve OAT retention and HIV RNA suppression to continue reducing AIDS mortality.

Keywords: AIDS; HIV; Mortality; People who inject drugs.

Publication types

  • Observational Study

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy
  • Acquired Immunodeficiency Syndrome / immunology
  • Acquired Immunodeficiency Syndrome / mortality*
  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Opiate Substitution Treatment / statistics & numerical data*
  • RNA, Viral / drug effects*
  • Spain / epidemiology
  • Substance Abuse, Intravenous / complications
  • Substance Abuse, Intravenous / immunology
  • Substance Abuse, Intravenous / mortality*
  • Viral Load / drug effects*

Substances

  • RNA, Viral