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Læknaneminn - 01.04.1997, Page 99

Læknaneminn - 01.04.1997, Page 99
The drug-AIDS hypothesis * TABLE5 Drug use by homosexuals with AIDS and at risk for AIDS DRUGS Atlanta' 1983: 50 AIDS, 120 at risk San Francisar 1987: 492 at risk San Francisco1 2 3 1990: 182 AIDS Chicago4 1993: 5000 at risk San Francisco5 6 1993: 215 AIDS* Vancouver'’ 1993: 136AIDS USA, Europe, Australia7 8 1994 AIDS London/ Manchester" 1996: 685 at rislc nitrite inhalants 96% 82% 79% 71-100% 100% 98% 50% ** 80% ethylchloride 35-50 18 cocaine 50-60 84 69 40-66 yes yes 12-34 40 amphetamines 50-70 64 55 26-46 yes yes 6-27 48 ecstasy 57 speed phenylcyclidine 40 22 23 yes LSD 40-60 49 yes 48 metaqualone 40-60 51 44 barbiturates 25 41 30 yes marijuana 90 85 88 41-68 76 heroin 10 20 3 yes 25 alcohol 46 95 90 95 cigarettes 33 yes 50 58 AZT most most 15-64 drug free 0 0 0 0 0 0 0 0 1) Jaffe, H. W„ Choi, K, Thomas, P. A„ Haverkos, H. W., Auerbach, D. M„ Guinan, M. E„ Rogcrs, M. E, Spira, T. J„ Darroiv, W. W„ Kramer, M. A„ Friedman, S. M„ Monroe, J. M„ Friedman-Kien, A. E„ Laubenstein, L. J„ Marmor, M„ Safai, B„ Dritz, S. K, Crispi, S. J„ Fannin, S. L„ Orkivis, J. P„ Kelter, A„ Rushing, W. R„ Thacker, S. B. and Curran, J. W. (1983) National case-control study of Kaposi’s sarcoma and Pneumocystis carinii pneu- monia in homosexual men: Part 1, Epidemiologic results. Ann. Intern. Med. 99: 145-151. 2) Darrow, W. W„ Echenberg, D. F, Jaffe, H. W„ OMalley, P. M„ Byers, R. H„ Getchell, J. P. and Curran, J. W. (1987) Risk factors for htiman immun- odeficiency virus (HIV) infections in homosexual men. Am. J. Publ. Health 77: 479-483. 3) Lifsoti, A. R„ Datroiv, W. W„ Hessol, N. A„ OMalley, P. M„ Bandmrt, J. L„ Jaffe, IL. W. and Rutherford, G. W. (1990) Kaposi's sarcotna in a cohort of hotnosexual and bisexual men: epidemiology and analysis for cofactors. Am. J. Epidetnio!. 131:221-231. 4) Kasloiv RA, Blackwelder WC, Ostroiv DG, Verg D, Palenicek J, Coulson AH, Valdiserri RO. No evidence for a role of alcohol or other psychoactive drugs iti accelerating imtnunodeficiency in HIV-1-positive individuals. J Atn MedAssoc 1989; 261:3424-3429; Ostrow DG, Beltran ED, JosephJG, DiFranceisco W, Wesch J, Chrniel JS. Recreational drugs and sexual behavior in the Chicago MACS/CCS cohort of hotnosexually active men. Journal of Substance Abtise 1993; 5:311-325; Ostroiv, D. G„ Van Radett, M. J„ Fox, R„ Kingsley, L. A„ Dudley, J„ Kaslow, R. A. and the Multicenter AIDS Cohort Study (MACS) (1990) Recreational drug tise and sexual behavior change itt a cohort of homosexual tnen. AIDS 4: 759-765. 5) Ascher, M. S„ Sheppard, H. W„ Winkelstein Jr, W. and Vittinghoff E. (1993) Does drug use cause AIDS? Nature (Lottdon) 362:103-104. Ellison, B. J„ Dowtiey, A. B. and Duesberg, P. H. (1996) HIVas a surrogate tnarkerfor drug-use: a re-analysis ofthe San Francisco Meris Health Study. In: AIDS: virus- or drtig induced?, pp. 97-104, Duesberg, P. H. (ed.) Kluwer Academic Publishers, Dordrecht, The Netherlands. 6) Schechter, M. T„ Ctaib, K. J. P„ Gelmon, K. A„ Montaner, J. S. G„ Le, T. N. and OShaughnessy, M. V. (1993) HIV-1 and the aetiology of AIDS. Laticet 341: 658-659. Craddock, M. (1996) A critical appraisal of the Vancotiver men’s study; does it refiite the drugs/AIDS hypothesis? In: AIDS: virus or drug-induced, pp. 105-110, Duesberg, P. H. (ed.) Kluwer Acadetnic Publishers, Dordrecht, Netherbind. 7) Veugelers PJ, Page KA, Tindall B, Schechter MT, Moss AR, Winkelstein WW, Cooper DA, Craib KJP, Charlebois E, Coutinho RA, Van Griensvett GJP. Determinants of HIVdiseaseprogression atnong homsextuú men registered in the tricontinental seroconverter study. Atnerican Jotirnal oj Epidetniology 1994; 140: 747-758. 8) Gibbons, J. (1996) Drttgs & Us. Gay Times (Londott) September, p 17-37. * See section 7. ** 6 month reported tise NIAID sponsored San Francisco Men’s Health Study also report that 98% of nitrite inhalant users are homo- sexuals 7,,8° (Table 4). Like male homosexuals from San Francisco 80, 101, 102 and Chicago/Baltimore/Los Angeles/Pittsburgh l03,10'1, those from Vancouver l02-105, Sidney 102, Amsterdam 102 and London 10<í'107 also show a specific affmity for nitrite inhalants, because of “their ability to briefly relax the smooth muscles of the anal sphincter and thereby facilitate penetration” 104 (see Table 5). The current American use can be estimated from British sales statistics because nitrites were legal in the UK until 1996, and because the drug use habits of the homosexual communities in the US and UK are com- LÆKNANEMINN 97 1. tbl. 1997, 50. árg.
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