Miami Herald Examines Research on Crack Users and HIV
The Miami Herald on Tuesday profiled the efforts of two researchers at hospitals in Atlanta and Miami to break the "grim cycle" in which crack users engage in risky sexual behavior, become HIV-positive and transmit the virus to others. Lisa Metsch of the University of Miami's School of Medicine and Carlos del Rio of Emory University's School of Medicine and Atlanta's Grady Memorial Hospital are testing an eight-session intervention program aimed at getting crack users into HIV and long-term drug treatment programs. The researchers presented their findings at the XVII International AIDS Conference in Mexico City on Monday.
For the study, the researchers interviewed 190 HIV-positive, sexually active crack users who were admitted to Grady Hospital and Jackson Memorial Hospital in Miami for HIV-related medical problems, such as infections, diarrhea, pneumonia and cancer. Del Rio and Metsch worked with the patients to get them in long-term HIV care, group counseling to reduce risky sex practices and drug treatment programs. The researchers paid patients $10 per counseling session. Del Rio and Metsch will report progress as the 14-month program continues. The program is part of a five-year nationwide study funded by NIH.
In interviews with the patients, the researchers aimed to learn which life situations were most likely to influence the drug users to have unsafe sex with an HIV-negative or unknown status partner. According to the researchers, hypersexuality associated with crack use and its users' heavy involvement in sex for the drug and money poses a significant risk of HIV. The researchers found that one-quarter of study participants reported having unprotected vaginal and/or anal sex with an HIV-negative or unknown status partner in the previous six months and that women were more likely to have unprotected sex, by 32% to 18%. Women also were more likely to be homeless, report annual income of less than $5,000 and not have health insurance. In addition, researchers found that half of the drug users had not seen an HIV specialist in the past six months and that three-quarters were not on antiretroviral drugs.
Del Rio said, "On average overall, the addicts have three diseases -- HIV, mental health problems like schizophrenia and substance abuse." Metsch said, "Too many people think HIV is just a chronic disease, and people can live very well with it if they take their meds," adding, "This group is not living good lives. They're engaged in hard-core drugs. They're at high risk" (Tasker, Miami Herald, 8/5).
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