Economic incentives to substance-abusing HIV patients are not helping them suppress the virus in the long-term, said a new study funded by the U.S. National Institute on Drug Abuse. Researchers said traditional treatments are still the best way to protect people.

A six-month treatment called patient navigation intervention seeks to provide people with deposits of $1,160 and 11 HIV treatment sessions. Researchers said the objective was to encourage patients to abandon drugs and “increase engagement in HIV care.”

National HIV Testing Day
June 27 marks the National HIV Testing Day in the U.S. Credit:

Patient navigation did not seem effective in the long-term when measuring the HIV viral load of participants. Results were not different when substance-abusing patients received financial incentives, in comparison with those who received traditional treatment.

“Patient navigation and financial incentives provided a short-run increase in engagement to care and viral suppression, but the primary outcome at six months after treatment completion was not significantly different,” said Daniel J. Feaster, associate professor in the Biostatistics Division of the Department of Public Health Sciences.

The investigation included data from 801 individuals of New York City, Boston, Atlanta, Miami, Los Angeles, Chicago and other five U.S. cities. Detailed results of the study were published on June, 12, in the Journal of the American Medical Association.

Money plus medical treatment: not the most effective combination, researchers concluded

Researchers said that most participants did not look for drug addiction treatment, while others didn’t have the opportunity because of  “limited harm-reduction services” in their region. Other patients were also affected by “social disadvantages, racism, poverty and HIV-related stigma.”

Professor Feaster said that drug-abusing patients who are HIV positive might need longer medical intervention or hospitalization. At the same time, they should receive treatment for substance use disorders, he added.

The most effective way to prevent the spread of HIV is to provide patients with treatment as soon as they are aware of the infection, added Feaster. This would reduce HIV consequences in the immune system.

Allan Rodriguez, a professor of clinical medicine and co-author of the study, suggested that a one-year intervention could probably show better results. He said it is fundamental to explore new treatments in what he calls “hard-to-engage populations.”

He remarked the importance of conducting HIV investigations in Miami. According to Rodriguez, Miami’s metropolitan area has the highest HIV infection case rate in the country. He suggested that drug addicts who are HIV positive, are less likely to attend treatment.

Rodriguez said that most substance-abusing HIV patients are aware of their HIV status but are not consistent at following a proper treatment. He said these patients should be intervened when they arrive at the hospital to help them achieve better outcomes in the future.

HIV in the U.S: 12.8 percent of people with the virus have not been diagnosed

There are an estimated 1.2 million people in the nation living with the human immunodeficiency virus. Every year, 45,000 people enter the list of diagnosed patients, according to the Centers for Diseases Control and Prevention (CDC).

The CDC said there are more alternatives than ever to prevent HIV. For instance, people at high risk of contracting the virus from sexual relationships, or drugs consumption, can take medicines such as Truvada. Using condoms is still the most effective method to practice safe sex.

People who test positive have more chances than ever of surviving. Rates of patients living with the virus in the U.S. have been increasing during the last years. 90 percent of new cases of HIV in the country could be prevented by treating people who are currently living with the virus.

According to the World Health Organization (WHO), only 54 percent of people with HIV in the world are aware of their infection. HIV can cause AIDS, a syndrome that weakens the immune system until it can no longer fight infections. 17 million people with the virus were receiving treatment by the end of 2015.

12.8  percent of 1.2 million Americans with HIV had not obtained a diagnosis by 2013, according to the CDC. In 2014, there were 44,073 new patients with HIV, of which 35,571 were males, and 8,328 were female.

UN: eradicating AIDS is key target for the 2030 Agenda on Sustainable Development

The Member States of the United Nations agreed on early June to eliminate AIDS as a public health threat. The new resolution is part of the 2030 Agenda on Sustainable Development, which considers elements such as climate change, hunger, and diseases.

90 percent of HIV-positive people should know their virus status and should receive antiretroviral therapy by 2030, said WHO. The new declaration recognized the link between poverty, development and HIV epidemics.

“This Political Declaration will enable countries to intensify and accelerate their HIV responses, to ensure that their HIV responses are fully integrated into the broader Agenda for Sustainable Development, and ultimately to end the AIDS epidemic,” said WHO in a press release.

Source: University of Miami Miller School of Medicine