Tuesday, August 7, 2007

Drug use is biggest factor in spread of HIV

Related behaviors also increase risk

MIAMI — Drug use and the resulting risky behavior are the biggest factors in the spread of HIV/AIDS in the United States, and Hispanic and black men are more likely to be infected this way than others, an AIDS expert told a national AIDS conference this month.

“Drugs, whether you inject them, inhale them or take them orally, alter your judgment and put you at risk for HIV,” Dr. Rhonda Hagler, medical director of Proceed Inc., an Elizabeth, N.J.-based AIDS clinic, told the 2007 National Conference on Latinos and AIDS.

Contracting AIDS through injected drug use is particularly crucial in the Hispanic and black communities, because Hispanic and black men were nearly three times as likely as non-Hispanic white men and nearly twice as likely as Asians to contract AIDS through shared needles, according to a U.S. Centers for Disease Control and Prevention survey in 2004.

Also, Hispanic teens are using drugs — from cocaine to heroin — at somewhat higher rates than blacks or non-Hispanic whites.

Hispanic and black women, on the other hand, were less likely to contract AIDS through drug use than non-Hispanic white and Asian women.

A first step in dealing with the situation, Hagler said, is to put aside prejudices against drug abusers.

“It’s not a moral issue,” she said. “If you’re addicted, you can’t stop. Nancy Reagan’s ‘Just say no’ doesn’t work. So much of HIV treatment of drug addicts is controlled by the opinion of the judge or the social workers. We need to seek expert research to get the scientific facts.”

An additional hardship for Hispanics, another speaker said, is that they tend to be tested later for HIV, the virus that causes AIDS.

“My patients with HIV have a higher viral load because they’ve been infected for a long time, and don’t have the resources to see a doctor,” said Dr. Jose Moreno, professor of clinical medicine at the University of Miami School of Medicine, in an interview last week. “Some of them may be illegal, and they’re afraid of being deported.”

In fact, 43 percent of Hispanics were diagnosed with HIV late in their illness — meaning the HIV progressed to AIDS within a year of the HIV diagnosis — compared with 37 percent of non-Hispanic whites, according to a 2006 report by the CDC. Only 45 percent of Hispanics have ever been tested for HIV, compared with 54 percent of non-Hispanic whites, the study said.

People who are drug-dependent and HIV positive face discouraging additional hurdles, Hagler told the conference, including:

• Higher suicide rates.

• Quicker progression from HIV to AIDS.

• Complicated and unexpected interactions between legal drugs and illegal ones. Alcohol intensifies the toxicity of cocaine, she said. Ritonavir, an HIV drug, increases the potency of Ecstasy and heroin.

• Reluctance of some doctors to give medicine for pain when needed for fear of increasing drug dependence. “A drug abuser gets cancer, and the doctor will only give him Tylenol because he doesn’t want to boost the addiction,” Hagler said.

Also at the conference, actress Rosie Perez, an AIDS activist for 20 years, urged unity in the fight.

“We get tired and frustrated from the apathy there is on this subject,” she said. “We must recommit every morning. We’re all brothers and sisters in this fight.”

source: The Buffalo News

Updated: 08/07/07 7:08 AM

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