[Effect of distinct sociodemographic variables on progression of HIV infection in a cohort of drug users].
OBJECTIVE
To analyze whether the effectiveness of combined antiretroviral therapy in delaying progression to AIDS and death is affected by social inequities in a cohort of HIV-positive injecting drug users (IDUs).


METHODS
A cohort of 3,122 HIV-positive IDUs identified in the AIDS Information and Prevention Centers of the autonomous region of Valencia was analyzed, with further follow-up in 1,876. Progression to AIDS and death after seroconversion were calculated by Kaplan-Meier estimation according to sociodemographic variables (age, sex, education, marital status, length of addiction). Cox regression models were also fitted.


RESULTS
No significant differences were observed according to the variables considered when analyzing time to AIDS development. Evaluation of survival time revealed that individuals with further follow-up showed an excess of mortality (HR = 1.35; 95%CI: 0.20-1.54). For individuals without follow-up, mortality risk was reduced in those with secondary school education (HR = 0.51; 95%CI: 0.35-0.74) and with university education (HR = 0.41; 95%CI: 0.18-0.93) compared with those with no education. When individuals with follow-up were analyzed, the differences lost significance for those with secondary school education (HR = 0.92; 95%CI: 0.72-1.19) and university education (HR = 0.62; 95%CI: 0.35-1.11).


CONCLUSIONS
The mortality excess found in IDUs with lower educational levels, especially among those not seeking healthcare in the initial period after being identified as HIV-positive, highlights the need for interventions aimed at facilitating access to health systems, especially among the socially disadvantaged.
Hurtado
Isabel
I
CIBER de Epidemiología y Salud Pública (CIBERESP), Valencia, España. hurtado_isa@gva.es
Hernández-Aguado
Ildefonso
I
Ferreros
Inmaculada
I
Lumbreras
Blanca
B
Pérez-Hoyos
Santiago
S
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006679:HIV Seropositivity / Q000188:drug therapy; D006801:Humans; D008297:Male; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications*
D044966:Anti-Retroviral Agents