HEALTHY MIND, HEALTHY BODY
HIV-positive people who enjoy good psychological well-being are more likely to adhere to their antiretroviral (ARV) regimen. In fact, in a recent study of mixed-HIV-status heterosexual couples, an absence of symptoms of depression was the only factor that predicted good adherence. Steven Safren, PhD, the director of behavioral medicine at Massachusetts General Hospital in Boston and the paper’s lead author, says that HIV treatment programs “should consider assessing and intervening with individuals who may have mental health concerns.” However, mental health treatment does not offer a clear-cut route to improved adherence rates. In some other studies, Safren points out, psychological treatment has improved mental health but not adherence rates. Just the same, he says that it’s vital to provide support for psychological health and for adherence. “Once their mental health is cleared up or improved a bit, then someone may be more likely to benefit from other forms of adherence support,” Safren says.
BOTH IMAGES: THINKSTOCK
Treating Addiction Helps HIV Opioid substitution treatment (OST) increases the likelihood that addicts will take their HIV antiretrovirals (ARVs) as prescribed. To determine this, researchers in British Columbia, Canada, followed 1,852 HIV-positive injection drug users (IDUs) for a median five and a half years between 1996 and 2010. While on OST, participants took ARVs 56 percent of the time; when not on OST, participants took ARVs 36 percent of the time. After accounting for various factors that may have influenced these rates, the researchers found that OST upped adherence by 68 percent. The study’s lead author, Bohdan Nosyk, PhD, a research scientist at the BC Centre for Excellence in HIV/AIDS and an associate professor at Simon Fraser University, attributes this beneficial effect of drug treatment to “the greater linkage to health care that comes with initiating OST, and also the stability that
OST can provide to people with opioid dependence.” Nosyk says that his study “demonstrates that comprehensive and integrated health care, incorporating addiction treatment in primary care, is clearly critical for the successful treatment of HIV-positive individuals who inject drugs.”
HIV-HEP C MORTALITY RISK
Hepatitis C virus (HCV) doesn’t significantly impact the risk of death unless it occurs along with other severe diseases, including HIV, cancer, chronic kidney disease or alcohol use disorders. This is according to research of 112,000 HCV-positive people hospitalized in France between 2008 and 2012. According to the leader of the study, Michaël Schwarzinger, MD, PhD, director of THEN (Translational Health Economics Network) in Paris, HIV infection was not linked to a higher risk of liver-related illnesses or death among the participants, but was associated with a raised risk of death from other causes.
poz.com SEPTEMBER 2015 POZ 29