ABSTRACT
The aim of the study was to analyze the impact of soci-economic status in addition to other risk factors in the progression of HIV disease in a cohort of injecting drug users (IDUs) with a mean follow-up of two years. Between 1989 and 1992, 124 HIV-infected IDUs were recruited in a primary care outpatient clinic providing free consultations and free access to therapy. The main outcome measures were death and AIDs-defining events. The proportion of current daily injectors at entry in the study and at the end of follow-up was 67.7% and 57.2%, respectively. The proportion of individuals on maintenance opioid therapy at entry in the study and at the end of follow-up was 0 and 12.1%, respectively. CD4 cell counts below 200 x 10(6)/L at baseline, positive p24 antigenemia at baseline, the lack of legal income and occasional drug use at entry were risk factors for clinical progression and death. When adjusted in a multivariate analysis, the absence of legal income remained associated with death and occurrence of an AIDS-defining event with a relative risk of 5.2 (1.5-18.1) (p = 0.004). Lack of legal income is a strong risk factor for progression of HIV disease in IDUs, that is independent of CD4 cell count and p24 antigenemia.
Subject(s)
HIV Infections/mortality , Substance Abuse, Intravenous/mortality , Acquired Immunodeficiency Syndrome/economics , Acquired Immunodeficiency Syndrome/etiology , Acquired Immunodeficiency Syndrome/mortality , Adult , Cohort Studies , Female , HIV Infections/complications , HIV Infections/economics , Humans , Income , Male , Multivariate Analysis , Paris/epidemiology , Risk Factors , Social Class , Socioeconomic Factors , Substance Abuse, Intravenous/complications , Substance Abuse, Intravenous/economicsABSTRACT
Treatment choices depend on the attitude of the abuser toward drugs, whether the patient is an occasional user or is drug-dependent. Disintoxication should be followed by further surveillance and, often, time away from the corrupting surroundings. Despite psychological support, relapses are common. For multiple relapsers, an important method is therapy in groups led by former drug abusers. Substitution treatment are not always miracle solutions.
Subject(s)
Substance-Related Disorders/therapy , Acquired Immunodeficiency Syndrome/complications , Female , Humans , Male , Substance-Related Disorders/complications , Substance-Related Disorders/rehabilitationABSTRACT
Of the synchroness slowing down of electrographic waves in animal experimently intoxicated with morphinic substances corresponds with the occurrance of addiction and tolerance to the products. In human's the progressive tolerance of the product can also be seen in course. This tolerance is accompagned by signs of dysfonction which question addiction to the product and its toxicity. Some of these signs are more specifically found in heroïnism.