AIDS and Behavior

, Volume 19, Issue 1, pp 81–84 | Cite as

Active Injection Drug-Abuse Offsets Healthcare Engagement in HIV-Infected Patients

Original Paper


Active injection drug use (IDU) is a behavior with the potential to offset healthcare engagement for those with HIV. At the Washington DC Veterans Affairs Medical Center, we identified 316 patients with a history of addiction during an 11-year period while actively engaged in routine visits to our HIV-primary care clinic. Among all IDU, active-abuse was determined in 141/316 (45 %). There were 120 clinically relevant blood stream infection (BSI) episodes. HIV/HCV co-infection (95 %) and use of antiretroviral therapy (76 %) were common at the time of BSI. The majority of BSIs occurred among those with active-IDU (72/120, 60 %). Active-IDU behavior was associated with more thrombotic disease (12 vs. 2 %, P = 0.001) and more frequent hospitalization (1.1/year ± 1.2 vs. 0.8/year ± 1.1, P = 0.03). When compared to drug-users with no active injection practices or those with remote IDU, active-IDU was associated with an increase in all-cause mortality (43 vs. 27 %, P = 0.003) and a decrease in age-adjusted survival (HR 1.7, CI 1.16–2.51, P = 0.007). Addressing addiction has the potential to impact avoidable medical complications and contribute to the continued, overall health of patients linked to HIV-care.


Drug-abuse Addiction HIV AIDS Mortality Bacteremia 


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Copyright information

© Springer Science+Business Media New York (outside the USA) 2014

Authors and Affiliations

  • Angelike P. Liappis
    • 1
    • 2
  • Ann M. Laake
    • 1
    • 2
  • Mark Delman
    • 2
  1. 1.Medical Service, Section of Infectious DiseasesVeterans Affairs Medical CenterWashingtonUSA
  2. 2.Department of MedicineThe George Washington University Medical CenterWashingtonUSA

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