A Rant On Who Receives Treatment In America

Clinical research at UCSF was conducted to measure the relationship between stimulant use and highly active antiretroviral therapy (HAART) in HIV positive males who have sex with other males (MSM). The study suggested that AIDS positive MSM that also use stimulants (like cocaine or methamphetamine) were not at an increased risk for AIDS-related mortality. However, MSM that use stimulants and begin a HAART regimen before having AIDS are 1.5 times more likely to experience HIV progression to AIDS.

The researchers seem to suggest that positive treatment outcomes can occur among stimulant-using males, a statement that contradicts the preconception that substance users cannot complete successful treatment regimens. More clearly, this research is used to advance the notion that stimulant users are potentially worth treating. 

The research article reflects the ethically dubious attitude towards treatment administration in the United States. In a country obsessed with efficiency and cost-benefit analyses, providing life-saving medications to vulnerable populations does not always appear to be a sound investment.

However, individuals should be actively identified, treated with antiretrovirals, and offered drug counseling. We shouldn’t need evidence to decide if stimulant users need help or are worth helping. We shouldn’t need to justify, defend, or make a case for why vulnerable groups merit public health and medical efforts.

Finally, a recent study suggested that when individuals of at risk groups recruit their peers to get tested for HIV, the rate at which people are positively diagnosed for HIV increases. If a social networking intervention is designed in tandem with medications and drug counseling, more cases of HIV can be identified earlier, antiretrovirals can be prescribed sooner, and a greater number of individuals can receive the life-saving treatment they may desperately need.

Offering a well-designed intervention that exploits social networking strategies, targets substance abuse, and improves health outcomes for HIV positive patients would be undoubtedly difficult and expensive. The effort would require a willingness-to-change assessment, costly medications, and competent medical providers. Yes, fiscal and medical resources need to be allocated intelligently, and implementing such a strategy may require diverting resources, but in the country with the greatest per-capita expenditure on healthcare, it seems reasonable to ask for efficacious social and medical interventions for populations that are often overlooked.

-Luis Garcia 

References:

HAART Treatment in Stimulant-Using MSM:

University of California, San Francisco (UCSF). "Antiretroviral therapy benefits HIV-infected stimulant users." ScienceDaily. ScienceDaily, 10 October 2014. .

Social Networking Strategies to Increase HIV Diagnoses:

Infectious Diseases Society of America. "Real-life social networking prompts people to get tested for HIV." ScienceDaily. ScienceDaily, 10 October 2014. .