Patients with HIV who use stimulants such as cocaine or methamphetamine derived life-saving benefits from being on antiretroviral therapy compared with HIV-positive patients who did not use stimulants, results of research published in Journal of Acquired Immune Deficiency Syndromes indicate.

“Patients with HIV who use stimulants and other substances often experience difficulties with accessing antiretroviral therapy, partially due to the concerns of healthcare providers that they will not be able take their medications as directed,” explained Adam W. Carrico, PhD, of the University of California San Francisco, and colleagues in a press release.

To determine if stimulant use is associated with progression to AIDS or all-cause mortality after initiating highly active antiretroviral therapy (HAART), the scientists followed 1,313 men who have sex with men (MSM) who initiated HAART. Marginal structure modeling was used to determine the cumulative proportion of visits where any stimulant use was reported.

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There was no significant association of any level of stimulant use with all-cause mortality, reported the investigators. No stimulant use was associated with increased AIDS-related or non-AIDS mortality separately.

Among the 648 patients without AIDS at HAART initiation, a second analysis indicated that stimulant use reported at 50% or more was associated with a 1.5-fold increase in the odds of progression to AIDS or all-cause mortality (adjusted odds ratio, 1.54; 95% CI: 1.02-2.33; P<0.05).

HIV-positive MSM that reported stimulant use appeared to face no greater overall risks for all-cause, AIDS-related, or non-AIDS mortality compared with non-stimulant users.

“Men without AIDS at HAART initiation who more frequently reported stimulant use demonstrated modestly increased odds of progression to AIDS or all-cause mortality,” concluded the researchers. More research on the effects of stimulant use on the effectiveness of HAART is needed.


  1. Carrico AW et al. Journal of Acquired Immune Deficiency Syndromes. 2014; doi: 10.1097/QAI.0000000000000364.