DRUG USERS NOT AS LIKELY TO GET AIDS TREATMENTS

WASHINGTON - Revolutionary AIDS drugs that have prolonged life for thousands
of people are less likely to reach an entire class of victims - those who
contracted the virus through drug use, the first national study of AIDS
treatment found.

Blacks, Latinos, people with Medicaid and those without health insurance
were all less likely to get the new drugs and other important health care -
particularly in early 1996, when the study began.

Two years later, the gap had narrowed for some groups - notably Latinos and
blacks. But it persisted for many others, including women, who are most
likely to get HIV through sex with a drug user and were also less likely to
be in treatment.

"It's very clear there is a great divide in HIV care between the haves and
the have-nots," said Dr.

Martin F. Shapiro of the University of California Los Angeles, lead author
of the study being published today in the Journal of the American Medical
Association.

Disparities in access to health care exist throughout the health system, not
just in AIDS treatment. But unlike other diseases, most people with the AIDS
virus can trace their infection to one of two sources: homosexual men or
intravenous drug users.

Part of the explanation is simple economics. People infected through
intravenous drug use, or sex with a drug user, generally have less money,
less education and more life problems - all of which keep them from getting
effective care. Someone who can't pay the rent or buy groceries or who is
addicted to drugs may find getting medical care a low priority.

"That tends to be much more of a down-and-out population in every way," said
Dr. Alvin F.

Poussaint, who studies racial disparities in health at Harvard Medical
School.

At the same time, the gay community has mobilized around the disease,
educating its members about treatment options and the importance of getting
care.

But while the AIDS epidemic hit homosexual men first, blacks are the fasting
growing group of victims, now accounting for nearly half of all new
infections, making the disparities in care even more alarming to public
health officials.

There are many AIDS clinics in the gay community but few that are targeted
to drug users, said Peter Lurie of Public Citizen's Health Research Group.

"The injection drug users are a relatively forgotten part of this epidemic,"
he said.