Hospitalized HIV-Infected Patients in the Era of Highly Active Antiretroviral Therapy

Metsch, Lisa R.; Bell, Christine; Pereyra, Margaret; Cardenas, Gabriel; Sullivan, Tanisha; Rodríguez, Allan; Gooden, Lauren; Khoury, Nayla M.; Kuper, Tamy; Brewer, Toye H.; Rı́o, Carlos del

doi:10.2105/ajph.2008.139931

Cited by 50 publications

(59 citation statements)

References 21 publications

(20 reference statements)

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“…They enter care later, are less likely to be in care consistently, and their outcomes are worse [19••, 20••, 21••, [22][23][24][25][26][27]. The data reviewed here show that there are many reasons that they may not be in care, but for many, uninsurance and underinsurance, as well as a fragmented and confusing health care system play a major role [13••, 19••, 20••, 21••, [22][23][24][25][26][27]38].…”

Section: Discussionmentioning

confidence: 99%

“…The authors and others conclude that efforts to better engage and retain minority patients in care, particularly minority women, could be instrumental in reducing gender and race disparities in mortality [21••, 22]. A number of additional studies published in the past 2 years confirm the finding that blacks and women appear to be less likely to enter care for their HIV disease, and when they do, they are more likely to miss medical visits, presumably leading to discontinuation of HAART [23][24][25][26][27][28].…”

Section: Disparities In Hiv/aids Care and Outcomes Of Carementioning

confidence: 99%

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HIV/AIDS in Women and Racial/Ethnic Minorities in the U.S.

Stone

2011

Curr Infect Dis Rep

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The clinical issues affecting women with HIV/AIDS differ little from those affecting men. However, current research shows that treatment and outcome disparities affect many women with HIV, hypothesized to result from a complex interplay of socioeconomic and gender role influences. These disparities are also a reflection of racial/ethnic differences in treatment and outcome, since 80% of women with HIV/AIDS are black or Hispanic. Women have unique needs for HIV prevention - both prevention of sexual transmission to or from sexual partners and prevention of perinatal transmission. Racial/ethnic minorities continue to be disproportionately affected by the HIV/AIDS epidemic in the U.S. Minorities are less likely to be in care and on HAART than others with HIV/AIDS. These disparities result in poorer outcomes for minorities, especially blacks, with HIV/AIDS. New strategies for optimizing engagement and retention in care, and for prevention hold great promise for women and minorities with HIV in the U.S.

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Section: Discussionmentioning

confidence: 99%

Section: Disparities In Hiv/aids Care and Outcomes Of Carementioning

confidence: 99%

HIV/AIDS in Women and Racial/Ethnic Minorities in the U.S.

Stone

2011

Curr Infect Dis Rep

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“…For example, among 3,722 patients with HIV/ AIDS, a history of drug use (injection drug use [IDU] and non-IDU) was significantly related to decreased receipt of ART and less time on ART [9]. Similarly, in a large sample (n=1038) of inpatients with HIV/AIDS, crack cocaine use and heavy drinking was associated with never having had a HIV-care provider and not receiving ART [32].…”

Section: Access/utilization/retention In Hiv Carementioning

confidence: 99%

Substance Use: Impact on Adherence and HIV Medical Treatment

2011

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Substance use is highly prevalent among people living with HIV/AIDS, is often comorbid with other mental health problems, related to poor HIV medical outcomes, and, is associated with poor medication and treatment adherence. The current review reports on the recent state of the literature in terms of substance use and its relation to HIV medication and treatment adherence, and offers recommendations for advancing treatment and secondary HIV prevention efforts. Identifying substance users within HIV primary care and developing, evaluating, and refining integrative substance use-mental health-adherence interventions may be clinically important targets for effective disease management and may contribute to secondary HIV prevention efforts.

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“…4,5 In a recent study we documented that over one third of 1038 HIV-infected inpatients hospitalized in two public hospitals of two major Southeastern cities reported crack use. 6 Crack use was associated with unprotected sexual intercourse and diminished utilization of outpatient HIV care and medications. 6 We hypothesize that these outcomes among HIV-infected crack users may be associated with their experiences of intimate partner violence (IPV).…”

Section: Introductionmentioning

confidence: 99%

Intimate Partner Violence Among HIV-Infected Crack Cocaine Users

Kalokhe

Paranjape

Bell

et al. 2012

AIDS Patient Care and STDs

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HIV-infected crack cocaine users are at high risk for HIV transmission and disease progression because they encounter difficulty practicing safe sex, entering and remaining in HIV care, and taking antiretroviral therapy (ART). We hypothesized intimate partner violence (IPV) occurs frequently in this population and contributes to these shortcomings. From December 2006 to April 2010 inpatient HIV-infected crack users were recruited from Grady Memorial (Atlanta, GA) and Jackson Memorial Hospitals (Miami, FL). Participants were screened for IPV using a 5-item tool that was adapted from a previously validated instrument, the STaT. IPV survivors were questioned about support service utilization. Multivariable analysis was conducted to evaluate the association between IPV and unprotected sexual intercourse and sexually transmitted infection (STI) diagnosis in the prior 6 months, use of outpatient HIV care in the past year, and current ART use. We enrolled 343 participants, the majority African Americans of low socioeconomic status. The estimated IPV prevalence was 56%, highest in women (68%) and gay, bisexual, and transgendered men (71%). In multivariable analysis, IPV was associated with diminished ART use (adjusted prevalence ratios [adjPRs] 0.57; 95% confidence interval [CI] 0.41-0.80), unprotected sexual intercourse (adjPR 1.34; 95% CI 1.08-1.68) and STI diagnosis in the prior 6 months (adjPR 3.49; 95% CI 1.60-7.62). After experiencing abuse, IPV survivors most commonly turned to emergency services; however, 38% reported not using any supportive services. This study highlights that IPV occurs frequently among HIV-infected crack users and is associated with outcomes known to facilitate HIV transmission and disease progression. Reduced utilization of outpatient HIV care, ART nonadherence, and new STI diagnoses in this population should trigger IPV screening and support services referral.

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Hospitalized HIV-Infected Patients in the Era of Highly Active Antiretroviral Therapy

Cited by 50 publications

References 21 publications

HIV/AIDS in Women and Racial/Ethnic Minorities in the U.S.

HIV/AIDS in Women and Racial/Ethnic Minorities in the U.S.

Substance Use: Impact on Adherence and HIV Medical Treatment

Intimate Partner Violence Among HIV-Infected Crack Cocaine Users

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