The AIDS Care Cohort to Evaluate Access to Survival Services (ACCESS) investigates how social, economic, physical, policy, and individual factors impact the health and well-being of HIV-positive illicit drug users.
- To analyze the implementation, uptake and impact of new and emerging treatments for HIV infection and related comorbidities on the achievement and maintenance of optimal HIV treatment and disease outcomes
- To investigate the impacts of existing and emerging illicit drug use patterns and evolving approaches to addiction treatment on HIV treatment and disease outcomes
- To explore the impacts of social, structural and economic factors on HIV disease outcomes
- To continue to collect data that facilitate comparisons between HIV-positive and HIV-negative PWID in analyses that examine health service use, morbidity, and mortality
Notable findings from ACCESS include:
- Residential eviction raises risk of detectable HIV viral load
- Recent increases in transmitted drug resistance
- Cocaine use attenuates link between methadone and optimal HIV treatment outcomes
The cohort has produced more than thirty articles as of 2017 in publications including Addition, Clinical Infectious Diseases, and Lancet.
ACCESS is investigating many new areas including:
- HIV-associated comorbidities for HIV+ PWUD:HCV, pain, depression/anxiety, TBI, PTSD
- Use Veterans Aging Cohort Study (VACS) Index for disease progression
- Impacts of gentrification and stigma (anti-drug user, anti-HIV+)
- Medical/non-medical cannabis use in the era of regulated access and impacts of new regulatory approaches (dealing, criminalization, access)
- Impact of new official/non-official treatment approaches for substance use disorders, especially OUD (Suboxone, SROM, diacetylmorphine; cannabis, kratom, coca leaf tea)