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AIDS Behav. 2017 Apr;21(4):1138-1148. doi: 10.1007/s10461-016-1584-6.

Prevalence and Predictors of Substance Use Disorders Among HIV Care Enrollees in the United States.

Author information

1
Alcohol & Drug Abuse Institute, University of Washington, Box 354805, 1107 NE 45th Street, Suite 120, Seattle, WA, 98105-4631, USA. hartzb@u.washington.edu.
2
Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA.
3
Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
4
Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
5
School of Medicine, University of California, San Francisco, CA, USA.
6
Department of Medicine, University of California, San Diego, CA, USA.
7
School of Medicine, Harvard University, Boston, MA, USA.
8
School of Public Health, Harvard University, Boston, MA, USA.
9
Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
10
Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
11
Center for Global Health, Johns Hopkins University, Baltimore, MD, USA.
12
Department of Medicine, University of Alabama, Birmingham, AL, UK.
13
Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
14
Alcohol & Drug Abuse Institute, University of Washington, Box 354805, 1107 NE 45th Street, Suite 120, Seattle, WA, 98105-4631, USA.
15
Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.

Abstract

Prior efforts to estimate U.S. prevalence of substance use disorders (SUDs) in HIV care have been undermined by caveats common to single-site trials. The current work reports on a cohort of 10,652 HIV-positive adults linked to care at seven sites, with available patient data including geography, demography, and risk factor indices, and with substance-specific SUDs identified via self-report instruments with validated diagnostic thresholds. Generalized estimating equations also tested patient indices as SUD predictors. Findings were: (1) a 48 % SUD prevalence rate (between-site range of 21-71 %), with 20 % of the sample evidencing polysubstance use disorder; (2) substance-specific SUD rates of 31 % for marijuana, 19 % alcohol, 13 % methamphetamine, 11 % cocaine, and 4 % opiate; and (3) emergence of younger age and male gender as robust SUD predictors. Findings suggest high rates at which SUDs occur among patients at these urban HIV care sites, detail substance-specific SUD rates, and identify at-risk patient subgroups.

KEYWORDS:

HIV care settings; Patient demography; Substance use disorders; United States

PMID:
27738780
PMCID:
PMC6089366
DOI:
10.1007/s10461-016-1584-6
[Indexed for MEDLINE]
Free PMC Article

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