Recreational Drug Use in People Living with HIV in Spain: Factors Associated with Drug Use and the Impact on Clinical Outcomes

Abstract

We analysed the impact of recreational drug use (RDU) on different outcomes in people living with HIV (PLHIV). A multicentre retrospective cohort study was performed with two cohorts of PLHIV included: people using recreational drugs (PURD) vs. people not using recreational drugs (PNURD). Overall, 275 PLHIV were included. RDU was associated with men having sex with men (OR 4.14, 95% CI [1.14, 5.19]), previous sexually transmitted infections (OR 4.00, 95% CI [1.97, 8.13]), and current smoking (OR 2.74, 95% CI [1.44, 5.19]). While the CD4/CD8 ratio increased amongst PNURD during the follow-up year, it decreased amongst PURD (p = 0.050). PURD presented lower scores of self-reported and multi-interval antiretroviral adherence (p = 0.017, and p = 0.006, respectively), emotional well-being (p < 0.0001), and regular follow-up (p = 0.059), but paid more visits to the emergency unit (p = 0.046). RDU worsens clinical, immunological, and mental health outcomes amongst PLHIV.

Primary health care providers’ views on managing substance use among people living with HIV

“…Fourthly, transcripts of the interviews were sent to the participants to enable them to correct their interpretation. Finally, all edited transcripts were uploaded into ATLAS.ti, 7 a computerised qualitative data analysis software program for data management and coding. No names were recorded to ensure anonymity.…”

“…The repeated reading of the transcripts was used to develop a code list in the ATLAS.ti. 7 Firstly, the emerging preliminary codes relevant to the study objectives were identified. Secondly, deductive codes from the data were added, and code lists were grouped, regrouped and refined, including primary and secondary codes ( Figure 1 ).…”

“…The most studied reported that poor ART adherence is caused by intoxication and forgetfulness after substance use. 5 , 7 , 8 …”

Amphetamine‐related intoxications in people living with HIV: An observational study in an emergency department in Barcelona (Spain) from 2018 to 2020

“…However, the impact of recreational drug use on the management of HIV infection has been observed in the risk of transmission of infectious diseases, mainly sexually transmitted diseases [17,18] because of the higher prevalence of risk behaviours associated with drug use [19] and a negative impact on ART adherence [18,20,21], leading to a subsequent risk of therapy failure [21]. By contrast, other clinical complications of recreational drug use, such as drug intoxication and especially acute amphetamine intoxication, are a leading cause of mortality in people living with HIV [22][23][24][25][26][27].…”