Differences in social and mental well-being of long-term survivors among people who inject drugs and other participants in the Swiss HIV Cohort Study: 1980 – 2018. Antiviral Therapy
Kusejko et al. aimed to study social, clinical and mental factors of long-term survivors (LTS) in the Swiss HIV Cohort Study, with a particular focus on people who inject drugs (PWID). LTS were defined as individuals who survived at least 15 years after diagnosis of HIV.
The authors quantified differences between PWID LTS, and men who have sex with men (MSM) and heterosexual (HET) LTS. The used phylogenetic methods to distinguish between heterosexual LTS who most likely shared a social network with PWID at the time of infection, termed clusteredHET, and those who did not, termed HET not clustered (HETnc). The analysis was performed using data collected at least 15 years post diagnosis.
Overall, 1,663 of 5,686 (29.2%) PWID were LTS. The study found significant differences between PWID LTS and MSM/HETnc LTS regarding self-reported depression (59.4% versus 43.3%; odds ratio [OR]=1.8; P<0.001), incarceration (30.6% versus 7.0%; OR=6.9; P<0.001) and full work ability (25.4% versus 59.0%; OR=0.27; P<0.001). ClusteredHET were less vulnerable with respect to these variables than PWID LTS but more at risk compared with MSM/HETnc LTS, indicating that clusteredHET are closer to PWID with regard to social and mental aspects compared with all MSM/HETnc.
In conclusion, even 15 years post HIV diagnosis, there are significant differences regarding social and mental well-being between PWID and other SHCS sub-populations. The results show that, although HIV transmission among PWID has virtually stopped in Switzerland, special care for HIV-positive PWID is still needed.