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A Report From the Multicenter AIDS Cohort Study

Richard A. Kaslow, MD, MPH; William C. Blackwelder, PhD; David G. Ostrow, MD, PhD; Diane Yerg, MSPH; John Palenicek, PA-C; Anne H. Coulson; Ronald O. Valdiserri, MD, MPH

JAMA. 1989;261(23):3424-3429.

Abstract
In a multicenter cohort study of homosexual men, the proportion of seropositives at enrollment who developed the acquired immunodeficiency syndrome (AIDS) during the following 18 months ranged from 5.5% to 8.2% in 1597 alcohol drinkers vs 9.2% in 109 nondrinkers with no clear trend according to use, and from 6.3% to 9.6% for 1662 users vs 7.2% for 83 nonusers of psychoactive drugs prior to enrollment. Among seropositive men with low initial T helper lymphocyte counts, those who continued to use drugs showed no significantly higher 18-month risk of AIDS than nonusers (13% vs 10%); the corresponding risks were 13% and 15%, respectively, for continued heavier vs continued lighter consumption of alcohol. No other manifestations of immunodeficiency were positively associated with substance use prior to enrollment. Prior use was not associated with low mean T helper cell counts at enrollment, and continued drug or alcohol use after enrollment was not associated with greater subsequent decline in counts. As used in a large cohort of homosexual men, psychoactive substances did not enhance the progression of human immunodeficiency virus infection.

(JAMA. 1989;261:3424-3429)

Author Affiliations
From the National Institute of Allergy and Infectious Diseases, National Institutes of Health. Bethesda, Md (Drs Kaslow and Blackwelder and Ms Yerg); Howard Brown Memorial Clinic and Northwestern University, Chicago, III (Dr Ostrow); The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md (Mr Palenicek); the University of California Schools of Public Health and Medicine, Los Angeles (Ms Coulson); and the University of Pittsburgh (Pa) Graduate School of Public Health (Dr Valdiserri). Dr Ostrow is currently with the Department of Psychiatry and Institute for Social Research, University of Michigan, Ann Arbor.

Footnotes
A complete list of the participants in this research study appears at the end of this article.

Reprint requests to the National Institutes of Health, Bldg WW, Room 739, Bethesda, MD 20892 (Dr Kaslow).

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