HIV AS A SURROGATE MARKER FOR DRUG-USE - A REANALYSIS OF THE SAN-FRANCISCO MENS HEALTH STUDY

Our analysis of drug use and morbidity data from a cohort of 1034 men yields the following results: 1) HIV infection is a strong indicator o f drug use - HIV-positive respondents reported an average lifetime dos e of recreational drugs (excluding marijuana) 2.3 times higher than HI V-negative respondents. 2) Homosexuality is a strong indicator of drug use - homosexual respondents reported an average lifetime dose 2.0 ti mes higher than heterosexual respondents. 3) The incidence of AIDS-def ining diseases was not limited to respondents infected with HIV, but w as almost completely limited (98%) to respondents who reported using d rugs. We also address a previous report (Ascher er al., 1993) that was based on the same database and purported to show that HIV alone corre lates with the development of AIDS. Specifically, we show that the rel ationship between HIV infection and CD4+ T Cell loss is weaker than re ported by Ascher et al., and provides little evidence for a causative relationship. These results support the hypothesis that long-term, hab itual drug use can cause the conditions known as AIDS (independent of the presence of HIV), and refute the hypothesis that HIV alone causes these conditions independent of drug use.