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AIDS Behav. 2018 Mar;22(3):971-985. doi: 10.1007/s10461-017-1863-x.

Substance Use, Violence, and Antiretroviral Adherence: A Latent Class Analysis of Women Living with HIV in Canada.

Author information

1
Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
2
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
3
Centre for Addictions Research of British Columbia, University of Victoria, Victoria, Canada.
4
Department of Anthropology, University of Victoria, Victoria, Canada.
5
Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, Canada.
6
British Columbia Centre on Substance Use, Vancouver, Canada.
7
Oak Tree Clinic, BC Women's Health Centre, Vancouver, Canada.
8
Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, Canada.
9
McGill University Health Centre, Montreal, Canada.
10
Department of Family Medicine, McGill University, Montreal, Canada.
11
Women's College Research Institute, Women's College Hospital, Toronto, Canada.
12
Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada. kangela@sfu.ca.
13
Faculty of Health Sciences, Simon Fraser University, Blusson Hall Room 10522, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. kangela@sfu.ca.

Abstract

We used latent class analysis to identify substance use patterns for 1363 women living with HIV in Canada and assessed associations with socio-economic marginalization, violence, and sub-optimal adherence to combination antiretroviral therapy (cART). A six-class model was identified consisting of: abstainers (26.3%), Tobacco Users (8.81%), Alcohol Users (31.9%), 'Socially Acceptable' Poly-substance Users (13.9%), Illicit Poly-substance Users (9.81%) and Illicit Poly-substance Users of All Types (9.27%). Multinomial logistic regression showed that women experiencing recent violence had significantly higher odds of membership in all substance use latent classes, relative to Abstainers, while those reporting sub-optimal cART adherence had higher odds of being members of the poly-substance use classes only. Factors significantly associated with Illicit Poly-substance Users of All Types were sexual minority status, lower income, and lower resiliency. Findings underline a need for increased social and structural supports for women who use substances to support them in leading safe and healthy lives with HIV.

KEYWORDS:

Antiretroviral adherence; HIV/AIDS; Substance use; Violence; Women

PMID:
28733919
DOI:
10.1007/s10461-017-1863-x

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