Cocaine and AIDS

A new study finds continued crack cocaine abuse decreases AIDS therapy adherence by HIV-infected Black women. Because improper adherence to AIDS drug therapy has been linked to the development of drug resistant strains of HIV, the results of this study underscore the public health dangers of "harm reduction" programs-- especially for those living with or at risk for HIV-- that enable continued drug abuse.

Health & Medicine Week
May 10, 2004

AIDS/HIV THERAPY: Crack cocaine use reduces antiviral therapy use in women with HIV

Crack cocaine use decreases adherence to antiretroviral treatment among HIV-infected Black women.

"Since the appearance of crack cocaine in the 1980s, unprecedented numbers of women have become addicted. A disproportionate number of female crack users are Black and poor. We analyzed interview data of HIV-infected women greater than or equal to 18 years of age reported to 12 health departments between July 1997 and December 2000 to ascertain if Black women reported crack use more than other HIV-infected women and to examine the relationship between crack use and antiretroviral treatment (ART) adherence among Black women," researchers in the United States report.

"Of 1,655 HIV-infected women, 585 (35%) were nonusers of drugs, 694 (42%) were users of other drugs, and 376 (23%) were crack users," said Tanya Telfair Sharpe and colleagues at the Centers for Disease Control and Prevention. "Of the 1,196 (72%) Black women, 306 (26%) were crack users. We used logistic regression to examine the effect of crack use on adherence to ART, controlling for age and education among Black women.

"In multivariate analysis, crack users and users of other drugs were less likely than non-users to take their ART medicines exactly as prescribed (odds ratio OR =0.37; 95% confidence interval CI =0.24-0.56), OR=0.47; 95% CI=0.36-0.68), respectively."

The investigators concluded, "HIV-infected Black women substance users, especially crack cocaine users, may require sustained treatment and counseling to help them reduce substance use and adhere to ART."

Sharpe and her coauthors published their study in the Journal of Community Health (Crack cocaine use and adherence to antiretroviral treatment among HIV-infected black women. J Commun Health, 2004;29(2):117-127).

For additional information, contact Tanya Telfair Sharpe, National Center on Birth Defects and Developmental Disabilities/Fetal Alcohol Syndrome Prevention Team, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-86, Atlanta, GA 30333, USA. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..

Publisher contact information for the Journal of Community Health is: Kluwer Academic-Human Sciences Press, 233 Spring Street, New York, NY 10013-1578, USA.

The information in this article comes under the major subject areas of AIDS/HIV Therapy, Addiction Medicine, Minority Health, Disease Associations, and Women's Health.

This article was prepared by Health & Medicine Week editors from staff and other reports. Copyright 2004, Health & Medicine Week via &