Alcohol and drug use severity are independently associated with antiretroviral adherence in the current treatment era.
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| Title: | Alcohol and drug use severity are independently associated with antiretroviral adherence in the current treatment era. |
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| Authors: | Ma, J., Luu, B., Ruderman, S. A., Whitney, B. M., Merrill, J. O., Mixson, L. S., Nance, R. M., Drumright, L. N., Hahn, A. W., Fredericksen, R. J., Chander, G., Lau, B., McCaul, M. E., Safren, S., O'Cleirigh, C., Cropsey, K., Mayer, K. H., Mathews, W. C., Moore, R. D., Napravnik, S. |
| Source: | AIDS Care. May2024, Vol. 36 Issue 5, p618-630. 13p. |
| Subjects: | Clinical drug trials, HIV infection transmission, Substance abuse, Patient compliance, Self-evaluation, Statistical models, Antiretroviral agents, Methamphetamine, Academic medical centers, Viral load, Research funding, Multiple regression analysis, Questionnaires, Visual analog scale, CD4 lymphocyte count, Severity of illness index, HIV infections, Multivariate analysis, Descriptive statistics, Relative medical risk, Psychology of HIV-positive persons, Heroin, Men who have sex with men, Research, Cannabis (Genus), Alcoholism, Individualized medicine, Health outcome assessment, Comparative studies, Disease susceptibility, Infectious disease transmission, Confidence intervals, Drugs of abuse, Crack cocaine, Regression analysis, Evaluation, Disease risk factors, Adults |
| Geographic Terms: | United States |
| Abstract: | Substance use in people with HIV (PWH) negatively impacts antiretroviral therapy (ART) adherence. However, less is known about this in the current treatment era and the impact of specific substances or severity of substance use. We examined the associations of alcohol, marijuana, and illicit drug use (methamphetamine/crystal, cocaine/crack, illicit opioids/heroin) and their severity of use with adherence using multivariable linear regression in adult PWH in care between 2016 and 2020 at 8 sites across the US. PWH completed assessments of alcohol use severity (AUDIT-C), drug use severity (modified ASSIST), and ART adherence (visual analogue scale). Among 9400 PWH, 16% reported current hazardous alcohol use, 31% current marijuana use, and 15% current use of ≥1 illicit drugs. In multivariable analysis, current methamphetamine/crystal use, particularly common among men who had sex with men, was associated with 10.1% lower mean ART adherence (p < 0.001) and 2.6% lower adherence per 5-point higher severity of use (ASSIST score) (p < 0.001). Current and more severe use of alcohol, marijuana, and other illicit drugs were also associated with lower adherence in a dose-dependent manner. In the current HIV treatment era, individualized substance use treatment, especially for methamphetamine/crystal, and ART adherence should be prioritized. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Substance use in people with HIV (PWH) negatively impacts antiretroviral therapy (ART) adherence. However, less is known about this in the current treatment era and the impact of specific substances or severity of substance use. We examined the associations of alcohol, marijuana, and illicit drug use (methamphetamine/crystal, cocaine/crack, illicit opioids/heroin) and their severity of use with adherence using multivariable linear regression in adult PWH in care between 2016 and 2020 at 8 sites across the US. PWH completed assessments of alcohol use severity (AUDIT-C), drug use severity (modified ASSIST), and ART adherence (visual analogue scale). Among 9400 PWH, 16% reported current hazardous alcohol use, 31% current marijuana use, and 15% current use of ≥1 illicit drugs. In multivariable analysis, current methamphetamine/crystal use, particularly common among men who had sex with men, was associated with 10.1% lower mean ART adherence (p < 0.001) and 2.6% lower adherence per 5-point higher severity of use (ASSIST score) (p < 0.001). Current and more severe use of alcohol, marijuana, and other illicit drugs were also associated with lower adherence in a dose-dependent manner. In the current HIV treatment era, individualized substance use treatment, especially for methamphetamine/crystal, and ART adherence should be prioritized. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 09540121 |
| DOI: | 10.1080/09540121.2023.2223899 |
