Increased Risk Of HIV Is Associated With Crack Cocaine Smoking

Editor's Choice
Main Category: HIV / AIDS
Also Included In: Alcohol / Addiction / Illegal Drugs
Article Date: 19 Oct 2009 - 12:00 PDT

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A new study in the Canadian Medical Association Journal (CMAJ) reports that people who smoke crack cocaine are at increased risk of becoming HIV-infected. The study also indicates that smoking crack cocaine has considerably increased over the last several years.

These findings are alarming and highlight the urgent need for innovative public-health programs focusing on crack cocaine smokers.

Researcher examined a total of 1,048 injection drug users participating in the Vancouver Injection Drug Users Study in Vancouver, British Columbia. About 36 percent of participants were female, 26 percent self-identified as Aboriginal. At the start of the study the age average was 34 years. At enrolment the participants were HIV negative but by the end of the nine year study, 137 people contracted HIV.

In addition, the proportion of people who smoked crack cocaine daily jumped from 11.6 percent in the first three and a half year period to 39.7 percent in the last period.

Dr. Evan Wood of the BC Centre for Excellence in HIV/AIDS explains: "We have observed that use of crack cocaine has become one of the strongest risk factors for HIV seroconversion in Vancouver." According to the authors, this could be the result of mouth wounds caused from crack pipes making people more vulnerable to infection. In addition, relationship with more HIV-positive individuals could increase likelihood of HIV infection through sex and needle sharing. However, they were unable to evaluate these possible risk factors in the study.

The authors support the careful evaluation and implementation of innovative harm reduction programs to help crack cocaine smokers. This includes the controversial distribution of safer crack kits and supply of safe inhalation rooms. These interventions would give opportunities for health workers to engage with crack smokers and help attend to their other health care needs.

In an associated commentary, Dr. David Celentano and Dr. Susan Sherman of Johns Hopkins Bloomberg School of Public Health remark that "with the increasing proportion of injection drug users who are smoking crack cocaine, harm reduction programs need to address the unique needs of these people as part of a comprehensive HIV prevention strategy. Although controversial, the distribution of "crack kits" (glass stem with mouth piece, metal screen, lip balm and hand wipes) to this population has the potential to reduce HIV transmission."

"Smoking of crack cocaine as a risk factor for HIV infection among people who use injection drugs"
Kora DeBeck MPP, Thomas Kerr PhD, Kathy Li PhD, Benedikt Fischer PhD, Jane Buxton MD, Julio Montaner MD, Evan Wood MD PhD
CMAJ 2009. DOI:10.1503/cmaj.082054

"The changing landscape of crack cocaine use and HIV infection"
David Celentano ScD MHS, Susan G. Sherman PhD MPH
CMAJ 2009. DOI:10.1503/cmaj.091574
Canadian Medical Association Journal

Written by Stephanie Brunner (B.A.)
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