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

Matthew J. Mimiaga, Sari L. Reisner, Chris Grasso, Heidi M. Crane, Steven Safren, Mari M. Kitahata, Joseph E. Schumacher, W. Christopher Mathews, Kenneth H. Mayer

Research output: Contribution to journalArticle

79 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1457-1467
Number of pages11
JournalAmerican Journal of Public Health
Volume103
Issue number8
DOIs
StatePublished - Aug 2013
Externally publishedYes

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Cannabis
Crack Cocaine
Primary Health Care
Acquired Immunodeficiency Syndrome
HIV
Amphetamine
Opiate Alkaloids
Research
Unsafe Sex
Injections
Medication Adherence
Sexual Partners
Insurance Benefits
Sexual Behavior
Pharmaceutical Preparations
Public Health
Health
Therapeutics

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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. / Mimiaga, Matthew J.; Reisner, Sari L.; Grasso, Chris; Crane, Heidi M.; Safren, Steven; Kitahata, Mari M.; Schumacher, Joseph E.; Mathews, W. Christopher; Mayer, Kenneth H.

In: American Journal of Public Health, Vol. 103, No. 8, 08.2013, p. 1457-1467.

Research output: Contribution to journalArticle

Mimiaga, Matthew J. ; Reisner, Sari L. ; Grasso, Chris ; Crane, Heidi M. ; Safren, Steven ; Kitahata, Mari M. ; Schumacher, Joseph E. ; Mathews, W. Christopher ; Mayer, Kenneth H. / 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. In: American Journal of Public Health. 2013 ; Vol. 103, No. 8. pp. 1457-1467.
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