Problem opioid use and HIV primary care engagement among hospitalized people who use drugs and/or alcohol

Autor: Carlos del Rio, Lisa R. Metsch, Lacey Critchley, Daniel J. Feaster, Adam W. Carrico, Raul N. Mandler, Petra Jacobs, Allan Rodriguez, Natalie Gukasyan
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Drug
Adult
Male
medicine.medical_specialty
lcsh:Social pathology. Social and public welfare. Criminology
Alcohol Drinking
media_common.quotation_subject
Population
HIV Infections
Opioid
lcsh:HV1-9960
Drug Users
03 medical and health sciences
0302 clinical medicine
medicine
Humans
030212 general & internal medicine
Drug use
education
media_common
education.field_of_study
lcsh:R5-920
030505 public health
biology
Primary Health Care
business.industry
Illicit Drugs
HIV primary care
Public health
Research
Treatment as prevention
General Medicine
biology.organism_classification
Opioid-Related Disorders
Clinical trial
Analgesics
Opioid
Heroin
Hospitalization
Health psychology
Family medicine
Relative risk
Social Marginalization
Female
Cannabis
0305 other medical science
business
lcsh:Medicine (General)
Zdroj: Addiction Science & Clinical Practice, Vol 15, Iss 1, Pp 1-8 (2020)
Addiction Science & Clinical Practice
ISSN: 1940-0640
Popis: Background There is growing public health concern around the potential impact of the opioid crisis on efforts to eradicate HIV. This secondary analysis seeks to determine if those who report opioids as their primary problem drug compared to those who report other drugs and/or alcohol differ in engagement in HIV primary care among a sample of hospitalized people with HIV (PWH) who use drugs and/or alcohol, a traditionally marginalized and difficult to engage population key to ending the HIV epidemic. Setting and participants A total of 801 participants (67% male; 75% Black, non-Hispanic; mean age 44.2) with uncontrolled HIV and reported drug and/or alcohol use were recruited from 11 hospitals around the U.S. in cities with high HIV prevalence from 2012 to 2014 for a multisite clinical trial to improve HIV viral suppression. Methods A generalized linear model compared those who reported opioids as their primary problem drug to those who reported other problem drugs and/or alcohol on their previous engagement in HIV primary care, controlling for age, sex, race, education, income, any previous drug and/or alcohol treatment, length of time since diagnosis, and study site. Results A total of 95 (11.9%) participants reported opioids as their primary problem drug. In adjusted models, those who reported opioids were significantly less likely to have ever engaged in HIV primary care than those who reported no problem drug use (adjusted risk ratio, ARR = 0.84, 95% Confidence Interval, CI 0.73, 0.98), stimulants (ARR = 0.84, 95% CI 0.74, 0.95), and polydrug use but no alcohol (ARR = 0.79, 95% CI 0.68, 0.93). While not statistically significant, the trend in the estimates of the remaining drug and/or alcohol categories (alcohol, cannabis, polydrug use with alcohol, and [but excluding the estimate for] other), point to a similar phenomena—those who identify opioids as their primary problem drug are engaging in HIV primary care less. Conclusions These findings suggest that for hospitalized PWH who use drugs and/or alcohol, tailored and expanded efforts are especially needed to link those who report problem opioid use to HIV primary care. Trial registration This study was funded by National Institutes of Health (NIH) grant: U10-DA01372011 (Project HOPE—Hospital Visit as Opportunity for Prevention and Engagement for HIV-Infected Drug Users; Metsch); which is also a registered clinical trial under the Clinical Trials Network (CTN-0049). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Databáze: OpenAIRE
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