05:42pm Sunday 22 October 2017

Innovative Prevention Program in East Africa Seeks to Ensure Access to Care for Addicts with HIV

Anthony Amoroso, MD Anthony Amoroso, MD

Because many of these users inject the drugs, they are at risk from HIV from shared needles and once infected less likely to receive the care they need to survive. HIV is a significant problem in Tanzania and Kenya. In these countries, around five percent of the general population has the disease, a rate far higher than in the U.S. According to studies, HIV rates amongst injecting drug users (IDUs) are close to 20 percent. Nairobi, the capital of Kenya and its largest city, has between 6,000 and 12,000 IDUs. Overall, the country could have as many as 30,000 heroin users, with the coastal cities being the major hot spots. The number is small compared to the U.S., but it seems to be growing rapidly. Researchers and health officials worry that in East Africa, IDUs could become a key driver of the HIV epidemic.

Now, a new project led by researchers at the Institute of Human Virology (IHV) and the Department of Psychiatry at the University of Maryland School of Medicine (UM SOM) is trying to reduce these numbers by treating heroin addicts in Kenya with antiretrovirals and methadone. The project is led by Anthony Amoroso, MD, an associate professor of medicine at the IHV, as well as Chief of the Infectious Disease Section at the Baltimore VA Hospital. Dr. Amoroso is working with a clinical team led by Eric Weintraub, MD, from the UM SOM Department of Psychiatry. The project is being developed in conjunction with doctors at Mathari National Teaching Hospital, a government teaching hospital in Nairobi.

Methadone is a synthetic opioid that is commonly used to help people reduce their dependence on heroin and other opioids. It reduces withdrawal symptoms and craving and with proper dosing blocks the effects of illicit opioids. It is taken by mouth, and can help addicted individuals reduce their illicit drug use and adhere to HIV treatment.

“Heroin use is on the rise in Africa,” said Dr. Amoroso. “Access to appropriate care and treatment for these patients is really lacking because it is such a novel problem. In Nairobi, we have been working with the city government to improve the quality of HIV care with particular focus on decreasing mother-to-child transmission for over 5 years. We felt it is time to continue pushing for better services for those most affected and marginalized in these health systems. The University of Maryland School of Medicine has years of experience working with patients with IV drug addiction issues, including opioid addiction, concurrent mental illnesses, HIV infection and other infectious diseases, health policy, and social services. With the Department of Psychiatry engaged in our programming, we know we can make a real impact on helping countries struggling with emerging epidemics of IDU and HIV. The hope is that an effective demonstration will lead to scaling of services and ultimately make an impact on HIV prevention in key cities.”

The program began enrolling patients in December 2014. Over the next several months it will help around 1,400 patients and add another clinic in Nairobi. Over three years, the program will receive $2.2 million from the U.S. Centers for Disease Control and Prevention as part of a larger HIV care and treatment grant that Dr. Amoroso has been leading in Nairobi since 2010.

About the Institute of Human Virology

The University of Maryland School of Medicine was chartered in 1807 and is the first public medical school in the United States and continues today as an innovative leader in accelerating innovation and discovery in medicine. The School of Medicine is the founding school of the University of Maryland and is an integral part of the 11-campus University System of Maryland. Located on the University of Maryland’s Baltimore campus, the School of Medicine works closely with the University of Maryland Medical Center and Medical System to provide a research-intensive, academic and clinically based education. With 43 academic departments, centers and institutes and a faculty of more than 3,000 physicians and research scientists plus more than $400 million in extramural funding, the School is regarded as one of the leading biomedical research institutions in the U.S. with top-tier faculty and programs in cancer, brain science, surgery and transplantation, trauma and emergency medicine, vaccine development and human genomics, among other centers of excellence. The School is not only concerned with the health of the citizens of Maryland and the nation, but also has a global presence, with research and treatment facilities in more than 35 countries around the world.

About the University of Maryland School of Medicine

The University of Maryland School of Medicine was chartered in 1807 and is the first public medical school in the United States and continues today as an innovative leader in accelerating innovation and discovery in medicine. The School of Medicine is the founding school of the University of Maryland and is an integral part of the 11-campus University System of Maryland. Located on the University of Maryland’s Baltimore campus, the School of Medicine works closely with the University of Maryland Medical Center and Medical System to provide a research-intensive, academic and clinically based education. With 43 academic departments, centers and institutes and a faculty of more than 3,000 physicians and research scientists plus more than $400 million in extramural funding, the School is regarded as one of the leading biomedical research institutions in the U.S. with top-tier faculty and programs in cancer, brain science, surgery and transplantation, trauma and emergency medicine, vaccine development and human genomics, among other centers of excellence. The School is not only concerned with the health of the citizens of Maryland and the nation, but also has a global presence, with research and treatment facilities in more than 35 countries around the world.
medschool.umaryland.edu/

 

About the Institute of Human Virology

Formed in 1996 as a partnership between the State of Maryland, the City of Baltimore, the University System of Maryland and the University of Maryland Medical System, IHV is an institute of the University of Maryland School of Medicine and is home to some of the most globally-recognized and world-renowned experts in all of virology. The IHV combines the disciplines of basic research, epidemiology and clinical research in a concerted effort to speed the discovery of diagnostics and therapeutics for a wide variety of chronic and deadly viral and immune disorders – most notably, HIV the virus that causes AIDS. For more information, visit www.ihv.org


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