Intensified screening for HIV among injection drug users receiving opioid agonist therapy could prevent more than twice as many new infections as current screening practice. A recent study based on mathematical modeling found that screening every 6 months instead of annually, and adding viral RNA testing to the currently used HIV antibody testing, could improve both effectiveness and cost-effectiveness.
Active drug use before incarceration was associated with decreased engagement in HIV treatment among HIV-infected jail detainees. The severity of drug dependence correlated with worsening measures of engagement in HIV treatment. The study concludes that evidence-based treatment for drug abuse in jails may result in improved HIV treatment outcomes, which in turn could help slow HIV-transmission rates in the United States.
Study patients with HIV–hepatitis C coinfection progressed to successive degrees of severity of liver fibrosis 9 years sooner than those infected with HCV alone. Further findings from the study suggest that suppressing HIV with antiretroviral medications may slow HCV-related liver fibrosis.
Dr. Marilyn Huestis of NIDA’s Intramural Research Program talks about conducting research on drug effects with human subjects, developing tests to help law enforcement identify drugged drivers, and an assay to help identify children whose prenatal exposure to anti-HIV drugs may put them at risk for adverse developmental outcomes.
Patients were more likely to take a rapid HIV test when substance abuse treatment programs offered the test onsite rather than referred for offsite testing. Patients were equally likely to accept and learn their HIV status whether the offer of onsite testing was accompanied by 30 minutes of risk reduction counseling or by 5 minutes of brief information on the testing procedure. Onsite testing accompanied by brief information was cost effective, taking into account the projected lifetime costs of treatment and the gains in health and longevity for detected cases.
Despite the advances in treatment and prevention, roughly 50,000 new HIV infections still occur annually in the Nation. Research, in large part supported by NIDA, has produced a strategy to address this circumstance and break the epidemiological impasse: seek out HIV-infected individuals, particularly those in “hard-to-reach” groups that have minimal contact with the health care system; offer them HIV testing and treatment; and provide support to help them stay in treatment.
November 2011 Dr. Redonna K. Chandler of NIDA receives the Institute's 2011 Innovator Award for developing a method that fosters collaboration and data sharing on various studies of HIV in criminal justice populations.