Poor San Franciscans who are infected with HIV receive far too
few AIDS-fighting drugs that might prolong their lives and ease
their suffering, a UC-San Francisco study has found.
Of the 151 people studied, only 8 percent receive protease
inhibitors, which rank high among the heavy hitters of AIDS
medications. Only 28 percent take any anti-HIV drugs at all,
the team found.
By contrast, almost 90 percent of middle-class San Franciscans
infected with HIV receive medication for it, the scientists
"Poor people are increasingly the main high-risk group for
HIV," said one UCSF researcher, Andrew Moss.
The study was run by Dr. David Bangsberg of the UCSF AIDS
program at San Francisco General Hospital. It was presented at
the 12th World AIDS Conference in Geneva.
The scientists also discovered a marked discrepancy between the
patients' reported and actual compliance with drug-taking
schedules. Failure to stick to the schedule might cause them to
develop resistance to the medications, leaving them sicker than
To double-check patient claims, the scientists installed a
computer chip in the caps of bottles containing AIDS drugs. The
chip recorded each time the bottle was opened.
The researchers found the patients were taking an average of
only 80 percent of the pills. The patients claimed to have
swallowed 92 percent. The discrepancy is significant: If a
patient misses even a small number of drugs, his or her HIV
level can soar.
Moss said the patients "had to take more than 90 percent of
their medications to have a good chance of decreasing their
viral loads to an undetectable level."
At the San Francisco AIDS Foundation, some HIV-infected clients
skip medical appointments - especially those who don't feel
sick. Some do so because they feel they must deal with more
immediate day-to-day needs, such as locating food and shelter,
said registered nurse Tim Teeter, who was not connected with
either UCSF study.
Others who skip appointments include those whose judgment has
been impaired by mental illness or substance abuse, Teeter
Some clients are reluctant to start on AIDS-fighting drugs such
as protease inhibitors "because they're scared about the side
effects," Teeter said. "All of these medications have side
effects," Teeter explained. "If you've ever taken a course of
antibiotics for a medication, you know it can cause an upset
stomach. If you magnify that upset stomach by five to 10 times,
you're talking about the kinds of effects that these kinds of
(AIDS) drugs can cause."