Substance use among HIV-infected patients engaged in primary care in the United States: Findings from the centers for AIDS Research Network of Integrated Clinical Systems Cohort

M.J. Mimiaga, S.L. Reisner, C. Grasso, H.M. Crane, S.A. Safren, M.M. Kitahata, J.E. Schumacher, W.C. Mathews and K.H. Mayer

American Journal of Public Health, 2013, vol. 103, issue 8, 1457-1467

Abstract: Objectives. The purpose of this study was to better understand substance use behaviors and deleterious health consequences among individuals with HIV. Methods. We examined a multicenter cohort of HIV-infected patients (n = 3413) receiving care in 4 US cities (Seattle, Birmingham, San Diego, Boston) between December 2005 and April 2010 in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS). We used generalized estimating equations to model specific substance use outcomes. Results. Overall, 24% of patients reported recent use of marijuana; 9% reported amphetamine use, 9% reported crack-cocaine use, 2% reported opiate use, 3.8% reported injection drug use, and 10.3% reported polydrug use. In adjusted multivariable models, those who reported unprotected anal sex had higher odds of marijuana, amphetamine, injection drug, and polydrug use. An increased number of distinct vaginal sexual partners was associated with polydrug and crack-cocaine use. Nonadherence to antiretroviral therapy was associated with the use of all substances other than marijuana. Conclusions. The co-occurrence of substance use, unprotected intercourse, and medication nonadherence could attenuate the public health benefits of test, treat, and link to care strategies. Prevention programs are needed that address these coprevalent conditions. © 2013 American Journal of Public Health.

Keywords: addiction; adult; article; cohort analysis; female; human; Human immunodeficiency virus infection; male; middle aged; multivariate analysis; patient compliance; primary health care; sexual behavior; sexuality; statistics; United States, Adult; Alabama; California; Cohort Studies; Female; HIV Infections; Humans; Male; Massachusetts; Middle Aged; Multivariate Analysis; Patient Compliance; Primary Health Care; Sexual Behavior; Sexual Partners; Substance-Related Disorders; United States; Washington (search for similar items in EconPapers)
Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2012.301162_0

DOI: 10.2105/AJPH.2012.301162

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