GENEVA, Switzerland--A significant number of injection drug users in San Francisco who are HIV-positive do not receive protease inhibitors and may not even be aware of these medications--despite a commitment on the part of the city to make these drugs widely available.

"We found a lot of drug users were not taking the therapies, even though they were theoretically available to them. Many had not heard of the therapies, and some of them had heard of them but were still not taking them for whatever reasons," said Brian R. Edlin, MD, of the University of California San Francisco.

In a presentation here today (July 2) at the 12th World AIDS Conference, Edlin reported findings from a UCSF study on HIV therapy availability and adherence. Lead study investigator, he is a UCSF associate professor of health policy and community medicine and director of the UCSF Urban Health Study. Edlin noted that there is a bias against providing protease inhibitors, the powerful anti-HIV medications, to injection drug users because they are perceived as being poor adherers to treatment.

Nonetheless, the city has made it a policy to provide full access to these medications to all HIV-positive individuals. Federal guidelines also recommend that practitioners not discriminate in prescribing therapy on the basis of injection drug use, he said.

The UCSF research team set out to determine if, in fact, injection drug users were receiving the therapies.

Between October 1997 and March 1998, the research team interviewed 668 injection drug users in four San Francisco neighborhoods, testing them for HIV and questioning them about their knowledge of available HIV treatments. The researchers also conducted in-depth interviews with about a dozen individuals to help understand what factors might prevent or encourage those who were HIV-positive to adhere to combination therapy.

Sixty-three of the study participants (9.4 percent) were found to be HIV-positive.
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Contact: Corinna Kaarlela
corinna@irtsa.ucsf.edu
(415) 476-3804
University of California - San Francisco
2-Jul-1998