Slower uptake of HIV antiretroviral therapy among Aboriginal injection drug users

Abstract

We examined the time to antiretroviral therapy (ART) use among antiretroviral naïve HIV infected injection drug users participating in a prospective cohort study in Vancouver, Canada. Time to the initiation of ART was evaluated using Kaplan-Meier methods and Cox proportional hazards regression. The cohort was stratified based on Aboriginal and non-Aboriginal (primarily Caucasian) ethnicity. Between May 1996 and May 2003, 312 HIV-infected individuals were enrolled into the cohort. At 24 months after enrollment, the rate of ART use was 29.2% among Aboriginal participants and was 53.7% among non-Aboriginal participants (log-rank P=0.023), and lower uptake of ART persisted in multivariate analyses (relative hazard = 0.37 [95% CI: 0.15-0.93]; P = 0.035). These findings demonstrate lower uptake of HIV/AIDS care among Aboriginal injection drug users and demonstrate the need for interventions to improve access to HIV care among indigenous populations.