title: Slower uptake of HIV antiretroviral therapy among Aboriginal injection drug users.
abstract: OBJECTIVE
  We examined the time to antiretroviral therapy (ART) use among antiretroviral naïve HIV infected injection drug users participating in a prospective cohort study in Vancouver, Canada.
  
  
  METHODS
  Time to the initiation of ART was evaluated using Kaplan-Meier methods and Cox proportional hazards regression. The cohort was stratified based on Aboriginal and non-Aboriginal (primarily Caucasian) ethnicity.
  
  
  RESULTS
  Between May 1996 and May 2003, 312 HIV-infected individuals were enrolled into the cohort. At 24 months after enrollment, the rate of ART use was 29.2% among Aboriginal participants and was 53.7% among non-Aboriginal participants (log-rank P=0.023), and lower uptake of ART persisted in multivariate analyses (relative hazard = 0.37 [95% CI: 0.15-0.93]; P = 0.035).
  
  
  CONCLUSIONS
  These findings demonstrate lower uptake of HIV/AIDS care among Aboriginal injection drug users and demonstrate the need for interventions to improve access to HIV care among indigenous populations.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada. ewood@cfenet.ubc.ca
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Anita
authors.initials: A
authors.lastname: Palepu
authors.forename: Ruth
authors.initials: R
authors.lastname: Zhang
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: Mark W
authors.initials: MW
authors.lastname: Tyndall
authors.forename: Julio S G
authors.initials: JS
authors.lastname: Montaner
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hogg
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001955:British Columbia; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology; D006801:Humans; D007198:Indians, North American; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013997:Time Factors
chemical_list: D044966:Anti-Retroviral Agents