17th International AIDS Conference Mexico City, Mexico - August 13 - 18, 2008

CLINICAL OUTCOMES AND QUALITY OF LIFE: A PRELIMINARY LOOK AT HIV+ PARTICIPANTS ENROLLED IN A DOT PROGRAM

Int Conf AIDS. 2008 Aug 13-18;17 Abstract No. MOAB0202

E.K. Brandson, K.A. Fernandes, C.W. McInnes, E.F. Druyts, M. Tyndall, V.D. Lima, J.S.G. Montaner, R.S. Hogg
BC Centre for Excellence in HIV/AIDS, Vancouver, Canada

BACKGROUND: To evaluate clinical outcomes and quality of life among persons enrolled in a Maximally Assisted Therapy (MAT) DOT program.

METHODS: The Longitudinal Investigations into Supportive and Ancillary health services (LISA) cohort is a prospective study of HIV+ persons on antiretroviral (ARV) therapy. Participants were ≥18 years of age and recruited from the Drug Treatment Program at the BC Centre for Excellence in HIV/AIDS. An interview-administered survey collected information concerning drug and alcohol use, stigma (Berger), depression (CES-D 10), neighbourhood satisfaction (Ellaway), food insecurity (Radimer/Cornell), and quality of life (Holmes). Categorical variables were compared using Fisher’s Exact Test. Continuous variables were compared using the Wilcoxon Rank-Sum Test.

RESULTS: The LISA cohort consisted of 279 participants by 01/08, of which one quarter was enrolled in the MAT program. No difference emerged proportionally in viral suppression between MAT and other LISA participants (68% vs. 59%, respectively). CD4 counts at treatment initiation also revealed no differences, but improved for MAT participants by the time they had their interview (p=0.04). MAT participants were less likely to be employed (p=0.03) and have stable housing (p<0.01), and more likely to receive income assistance (p=0.01) compared to other participants. They were more likely to have been recently (past 6 months) incarcerated and co-infected with HCV (p<0.01). MAT participants were more likely to have ever used illicit drugs (crack p<0.01, cocaine p=0.01, and heroin p<0.01). They were also more likely to have be currently (p=0.01) enrolled in a methadone program. MAT participants reported lower perceived neighbourhood quality (p<0.01) and cohesion (p=0.03) and the quality of life scale showed less financial worries (p=0.04), HIV mastery (p-value=0.03), disclosure worries (p=0.01), and provider trust (p<0.01).

CONCLUSIONS: Preliminary findings demonstrate the success of this DOT program. MAT participants showed better or similar clinical outcomes compared with their peers in the cohort.

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2008-08-13
MOAB0202

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