Grant: CIHR Fellowship

Highly active antiretroviral therapy (HAART), the modern medical treatment for HIV disease, has dramatically reduced HIV-related illness and death. Despite this exciting development, major challenges remain, including ensuring access to HAART among HIV-infected drug users, a population with known barriers to HAART. In Canada, this population is largely comprised of the most vulnerable members of society and suffers from high levels of AIDS-related morbidity and mortality. Although treatments for opioid dependence are known to improve HAART outcomes among opioid-using patients, few evidence-based treatments exist for cocaine users, and little is known about ways to help HIV-positive cocaine users access and adhere to life-saving medications. This is concerning given a major increase in crack cocaine use during the past decade in Canada and considering that a substantial proportion of the HIV epidemic in Canada is attributed to cocaine use. Scientific research is urgently needed to identify effective treatments for cocaine addiction, which also confer clinical benefits on HAART outcomes among HIV-positive cocaine users. My proposed research with Drs. Evan Wood (a Tier 1 Canada Research Chair at the University of British Columbia) and Bohdan Nosyk (Endowed Chair in the Economics of HIV/AIDS at Simon Fraser University) aims to examine the impact of addiction treatment on HAART outcomes among HIV-positive cocaine users in Vancouver. I hypothesize that existing psychosocial treatments for cocaine dependence will not bring a significant benefit on HAART outcomes. However, as new pharmacological treatments for cocaine dependence will be tested in this setting, I hypothesize that these novel treatments will have significant benefits on HAART outcomes. The study findings are expected to inform efforts to identify evidence-based treatment models for HIV-positive cocaine users in Canada and beyond.