Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.  |
AIDS TREATMENT NEWS "alert" February 18, 2004
John S. James
This information was collected from 4,697 high-risk HIV-negative men who have sex with men, who were enrolled at 56 clinical-trial sites in the U.S. for the 36-month trial. Overall, there were 2.8 HIV infections per 100 person-years -- already considered a high number. But amphetamine users had 4.5 infections per 100 person-years, hallucinogen users had 4.0, and poppers users had 3.6. In this high-risk cohort there were many more users of poppers than of the other two put together -- 2176 reported poppers use, vs. 901 amphetamines and 603 hallucinogens -- suggesting a potentially large impact on the spread of HIV.
The drugs may be having this effect by making people more likely to take risks they would otherwise have avoided. Some drugs might also affect the immune system directly. In August 1999 AIDS Treatment News noted animal studies showing that exposure to "poppers" increased cancer growth(2) and bacterial growth(3), probably by suppressing the animals' natural immunity.
Comment
The higher rates of HIV infection found could also be due to selection bias -- if, for example, those who accept the risks of using illegal drugs also tend to take more risks in other areas, such as unprotected sex. The difference in this case is that the drugs would not be contributing to increased infection, but only identifying those already at higher risk. Both mechanisms could be involved, with drug both contributing to infection and also indicating who was already more likely to be infected.
References
| 1. | M Ackers, A Greenberg, C Lin and others. High HIV incidence among men who have sex with men participating in an HIV vaccine efficacy trials, United States, 1998-2002. Conf Retroviruses Opportunistic Infect. 2004 Feb 8-11;11th: Abstract No. 857. |
| 2. | Soderberg LSF. Increased tumor growth in mice exposed to inhaled isobutyl nitrite. Toxicol Lett. 1999 Jan 11;104(1-2):35-41. |
| 3. | Schafer R, Barnett J, Soderberg L, and Damiani C. Pulmonary exposure to isobutyl nitrite reduces resistance to a respiratory infection. 10th International Congress of Mucosal Immunology, Amsterdam, June 27 to July 1, 1999. |
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