BackgroundThere have been inconsistent findings on the association between current drug use and HIV disease progression and virologic suppression. Drug use was often measured using self-report of historical use. Objective measurement of current drug use is preferred.MethodsIn this cross-sectional study, we assessed drug use through Computer-Assisted Self Interviews (CASI) and point-of-care urine drug screen (UDS) among 225 HIV-infected patients, and evaluated the association between current drug use and virologic suppression.ResultsAbout half (54%) of participants had a positive UDS, with a lower self-reported rate by CASI (42%) (Kappa score = 0.59). By UDS, 36.0% were positive for marijuana, 25.8% for cocaine, 7.6% for opiates, and 2.2% for methamphetamine or amphetamine. Factors associated with virologic suppression (plasma HIV RNA <50 copies/mL) were Caucasian race (P = 0.03), higher CD4 count (P < 0.01), current use of antiretroviral therapy (ART) (P < 0.01), and a negative UDS (P < 0.01). Among 178 current ART users, a positive UDS remained significantly associated with lower likelihood of virologic suppression (P = 0.04).ConclusionsUDS had good agreement with CASI in detecting frequently used drugs such as marijuana and cocaine. UDS at routine clinic visits may provide “real-time” prognostic information to optimize management.
Este artículo argumenta que, a pesar de los distintos intentos institucionales por forjar una identidad latina, las mujeres puertorriqueñas y mejicanas adoptan frecuentemente una identidad nacional para configurar nociones dicótomas del "ser" y el "otro," basadas en valores culturales "patentes," que son a su vez, utilizados para explicar el éxito o el fracaso de éstas en el ámbito laboral, familiar o comunitario. Basado en una investigación etnográfica entre un grupo de puertorriqueñas en Chicago, este artículo presenta los distintos modos en que las puertorriqueñas y las mejicanas se comprenden unas a otras. Aunque por lo general estas representaciones est´n basadas en construcciones estereotipadas de lo que corresponde ser una "buena" mejicana o puertorriqueña, muchas mujeres se hacen de estos estereotipos y los transforman en virtudes culturales que las permiten distinguirse del "otro". Este artículo investiga estas construcciones de identidad étnica y de género, y examina cómo el grupo generacional, la política comunitaria local, los cambios en la economía politica local y nacional y la ideología familiar dan forma a la identidad de género entre las mejicanas y puertorriqueñas en Chicago.
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