Self-rated health and substance use among individuals in HIV care in Rio de Janeiro, Brazil: a cross-sectional study

Abstract

Self-rated health (SRH) is associated with morbidity and mortality in HIV-uninfected populations but is understudied in HIV. Substance use may affect SRH in addition to its deleterious effect on HIV disease. This analysis aimed to estimate SRH and substance use prevalence and evaluate factors associated with poor SRH among individuals in HIV care in Rio de Janeiro, Brazil. A convenience sample of HIV-infected adults completed one item of SRH, the Alcohol, Smoking and Substance Involvement Screening Test, and the Patient Health Questionnaire-2 (PHQ-2). Logistic regression models identified factors associated with poor SRH. Participants’ (n = 1029) median age was 42.9 years, 64.2% were male, and 54.5% were nonwhite. Poor SRH was reported by 19.5% and the use of alcohol, tobacco, marijuana, and crack/cocaine by 30.1, 19.5, 3.9, and 3.5%, respectively. Less than high school education (adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI]: 1.08–2.20), lack of sexual activity in previous 12 months (aOR 1.53, 95% CI: 1.01–2.30), crack/cocaine use (aOR 3.82, 95% CI: 1.80–8.09), positive PHQ-2 screen (aOR 3.43, 95% CI: 2.09–5.62), and HIV-1 RNA ≥40 c/ml (aOR 2.51, 95% CI: 1.57–4.02) were significantly associated with poor SRH as identified by logistic regression analyses. Alcohol, marijuana, and sedative use were not significantly associated with poor SRH. These results emphasize the need for substance use and mental health screening and treatment in this population. Further research may elucidate the consequences of poor SRH on treatment adherence, morbidity, and mortality in HIV-infected individuals.

HIV and Substance Use in Latin America: A Scoping Review

“…SU has also been linked to lower quality of life [ 21 , 132 , 133 , 134 , 135 , 136 , 137 ], poor sleep quality [ 25 ], discrimination [ 138 ] and gender identity stigma [ 139 ], although not with food insecurity [ 140 ].…”

Qualidade de vida de pessoas soropositivas: relação entre situação socioeconômica e estágio viral

“…Convergindo com os resultados do presente estudo, um artigo recente observou que uma PVHA sintomática não necessariamente possui menos QoL, o que se deve ao acesso universal ao tratamento e acompanhamento multiprofissional (9) . Isto pode ser explicado pelos novos medicamentos inseridos no protocolo nos últimos anos, que reduziram drasticamente os efeitos colaterais (37) .…”

“…O estágio do HIV era, no passado, um fator de risco para uma pior QoL de pessoas soropositivas (9) , no entanto novas opções de tratamento foram sendo desenvolvidas, o que aumentou a sobrevida e a melhora da QoL dos atingidos (10) . Um conjunto de ações através de medicamentos conjugados (3 em 1) e com menos efeitos colaterais inseridos nos protocolos clínicos, que facilitam a aderência ao tratamento (11) , bem como o melhor acolhimento nas unidades de saúde (12) , possibilitou importantes resultados frente à pandemia global (13) .…”

Association of Syndemic Conditions and Quality of Life among People Living with HIV/AIDS

“…A secondary analysis of the data collected in the project "Quality of life in a cohort of people living with HIV/AIDS" was performed [9,30]. Brie y, the project was a cross-sectional study conducted between 2014 and 2017.…”