African American/Black and Latino Adults with Detectable HIV Viral Load Evidence Substantial Risk for Polysubstance Substance Use and Co-occurring Problems: A Latent Class Analysis
| Autor: | Noelle R. Leonard, Mariam Ayvazyan, Belkis Y. Martinez, Marya Gwadz, Sabrina Cluesman, Leo Wilton, Amanda S. Ritchie, Linda M. Collins, Dawa Sherpa, Charles M. Cleland, Caroline Dorsen |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Social Psychology Substance-Related Disorders Population Substance Use Class HIV Infections 03 medical and health sciences 0302 clinical medicine Polysubstance use Barriers to the HIV care continuum medicine Humans 030212 general & internal medicine education Psychiatry education.field_of_study Original Paper 030505 public health business.industry Public health Public Health Environmental and Occupational Health HIV Hispanic or Latino Viral Load Mental health Latent class model United States Black or African American Distress Health psychology Infectious Diseases Cross-Sectional Studies Polysubstance dependence Latent Class Analysis New York City 0305 other medical science business |
| Zdroj: | AIDS and Behavior |
| ISSN: | 1573-3254 |
| Popis: | Substance use problems are highly prevalent among persons living with (PLWH) in the United States and serve as serious barriers to engagement in HIV care. Yet, in contrast to studies of single substances, little is known about patterns of polysubstance use in this population. Moreover, other risk factors (e.g., financial hardship, incarceration, homelessness, and mental health distress) are also prevalent and complicate HIV management. The present study drew on a cross-sectional survey with African American/Black and Latino (AABL) adult PLWH from low socioeconomic status backgrounds in New York City who were insufficiently engaged in HIV care and evidenced detectable HIV viral load (N = 512). We used latent class analysis (LCA) to explore patterns of polysubstance use and their relationships to financial hardship, incarceration, homelessness, and mental health. LCA yielded three substance use classes: Class 1, a high polysubstance use/high-risk substance use class (9%); Class 2, a polysubstance use/moderate substance use risk class (18%); and Class 3, a moderate polysubstance use/moderate-to-low-risk substance use class (74%). Mental health symptoms were prevalent in all classes, but Class 1 had greater mental health distress than the other two classes. Current homelessness was more prevalent in Classes 1 and 2. We cannot end the HIV epidemic without engaging and treating AABL PLWH who have serious barriers to engagement along the HIV care continuum, and who evidence polysubstance use along with co-occurring risk factors. Clinical settings can develop outreach and engagement approaches to bring this subpopulation of PLWH into care settings, and further, specialized services are needed to successfully screen, treat, and retain them. |
| Databáze: | OpenAIRE |
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