Substance use in older HIV-infected patients

Edelman, E. Jennifer; Tetrault, Jeanette M.; Fiellin, David A.

doi:10.1097/coh.0000000000000069

Cited by 37 publications

(28 citation statements)

References 119 publications

(110 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings are consistent with previous research (Justice et al, 2004; Rabkin et al, 2004) demonstrating that HIV-positive older adults who are engaged in HIV care experience substantial substance use problems that do not appear to resolve as they age (Edelman, Tetrault, & Fiellin, 2014). The majority of drug-using patients in this sample used marijuana, cocaine/crack, and stimulants, which is also consistent with previous research (Edelman et al, 2014; Mimiaga et al, 2013; Prentiss, Power, Balmas, Tzuang, & Israelski, 2004; Skeer et al, 2012). …”

Section: Discussionsupporting

confidence: 92%

Drug use among HIV+ adults aged 50 and older: findings from the GOLD II study

et al. 2016

View full text Add to dashboard Cite

Understanding the nexus of aging, HIV, and substance use is key to providing appropriate services and support for their aging, HIV seropositive patients. The proportion of PLWHA aged 50 and older is growing due to a variety of factors like decreases in mortality due to highly active retroviral therapy and non-negligible HIV incidence. We describe prevalence of alcohol, tobacco, and other drug use and participation in substance use treatment and 12-steps programs among 95 HIV-positive patients aged 50 and older engaged in care. Most (73.7%) smoked cigarettes in their lifetime and 46.3% were current smokers. Most were at medium (81.1%) or high risk (13.7%) for an alcohol use disorder. With respect to illicit drug use, 48.4% had used marijuana, cocaine, crack, methamphetamines, heroin, and/or prescription opiates without a prescription in the last 12 months; 23.2% met criteria for drug dependence. Marijuana was the most commonly reported illicit drug (32.6%) followed by cocaine and crack (10.5% each), heroin and prescription opiates (7.4% each), and methamphetamines (6.3%). Among those who had not used drugs in the past 12 months, 36.7% had been in a substance use treatment program and 26.5% had participated in a 12-step program in their lifetime; 8.2% were currently in treatment and 16.3% were currently participating in a 12-step program. Among those who had used an illicit drug in the past 12 months, 37.0% had never been in treatment, 34.8% had been in treatment in their lifetime, and 28.3% were currently in treatment. With respect to 12-step programs, 27.3% of those meeting dependence criteria had never participated, 45.5% had participated in their lifetimes, and 27.3% were currently participating. Our findings suggest that older adults in HIV care settings could benefit from Screening, Brief Intervention, and Referral to Treatment (SBIRT) interventions and/or integrated services for substance abuse and medical treatment.

show abstract

Section: Discussionsupporting

confidence: 92%

Drug use among HIV+ adults aged 50 and older: findings from the GOLD II study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Due to the relatively high prevalence of co-existing substance use disorders among persons with HIV, it is possible that PCPs who provide HIV care to a relatively large number of HIV-positive patients may be more comfortable or familiar with harm reduction approaches such as PrEP. 34,35 Results of studies have been mixed, with some showing a positive association between the number or proportion of HIV-positive patients for which a clinician provides care and surrogate measures of PrEP adoption, 12,31 while others have shown no association. 13,14,23 Our findings suggest that providers' concerns about the increase in risk behaviors and the safety of PrEP continue to be potential barriers to PrEP adoption.…”

Section: Discussionmentioning

confidence: 99%

A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians

et al. 2016

Self Cite

View full text Add to dashboard Cite

BACKGROUND: Among health care providers, prescription of HIV pre-exposure prophylaxis (PrEP) has been low. Little is known specifically about primary care physicians (PCPs) with regard to PrEP awareness and adoption (i.e., prescription or referral), and factors associated with adoption. OBJECTIVE: To assess PrEP awareness, PrEP adoption, and factors associated with adoption among PCPs. DESIGN: Cross-sectional online survey conducted in April and May 2015. RESPONDENTS: Members of a national professional organization for academic primary care physicians (n = 266). MAIN MEASURES: PrEP awareness, PrEP adoption (ever prescribed or referred a patient for PrEP [yes/no]), provider and practice characteristics, and self-rated knowledge, attitudes, and beliefs associated with adoption. KEY RESULTS: The survey response rate was 8.6 % (266/2093). Ninety-three percent of respondents reported prior awareness of PrEP. Of these, 34.9 % reported PrEP adoption. In multivariable analysis of provider and practice characteristics, compared with non-adopters, adopters were more likely to provide care to more than 50 HIV-positive patients (vs. 0, aOR = 6.82, 95 % CI 2.06-22.52). Compared with non-adopters, adopters were also more likely to report excellent, very good, or good selfrated PrEP knowledge (15.1 %, 33.7 %, 30.2 % vs. 2.5 %, 18.1 %, 23.8 %, respectively; p < 0.001) and to perceive PrEP as extremely safe (35.1 % vs. 10.7 %; p = 0.002). Compared with non-adopters, adopters were less likely to perceive PrEP as being moderately likely to increase risk behaviors ("risk compensation") (12.8 % vs. 28.8 %, p = 0.02). CONCLUSIONS: While most respondents were aware of PrEP, only one-third of PrEP-aware PCPs reported adoption. Adopters were more likely to have experience providing HIV care and to perceive PrEP as extremely safe, and were less likely to perceive PrEP use as leading to risk compensation. To enhance PCP adoption of PrEP, educational efforts targeting PCPs without HIV care experience should be considered, as well as training those with HIV care experience to be PrEP "clinical champions". Concerns about safety and risk compensation must also be addressed.

show abstract

“…Among people living with HIV/AIDS, alcohol use can be a negative predictor for issues such as adherence to antiretroviral therapy, risky sexual activity and systemic physiological effects [25]. us, among those who are HIV positive, combating this habit is a priority for viral suppression [26].…”

Section: Limitationsmentioning

confidence: 99%

Sociodemographic and Behavioral Factors Associated with HIV Vulnerability according to Sexual Orientation

Serra

Milhomem

Oliveira

et al. 2020

AIDS Research and Treatment

View full text Add to dashboard Cite

Objective. To analyze sociodemographic and behavioral factors associated with vulnerability to HIV according to sexual orientation. Method. is is a cross-sectional study conducted using data on 3,818 people in the city of Imperatriz, Brazil, during 2015 and 2016. e survey's questionnaires addressed sociodemographic and behavioral variables. For the data analysis, association (chi-square test) and strength of association (odds ratio) were observed. A significance level of 푝 < 0.05 and adjustment for age and gender were taken into consideration. Results. A substantial portion of the sample stated they were heterosexual (88.8%). ese individuals demonstrated a lower chance of HIV infection (푝 < 0.001), sexually transmitted infections (푝 < 0.001), alcohol use (푝 < 0.001) and condom use (푝 < 0.001), compared to men who have sex with men and/or bisexuals. In this group, a er adjusting for confounding variables, the factors associated with HIV infection were being male (푝 < 0.001), unmarried (푝 < 0.001), having completed higher education (푝 < 0.001) and boasting multiple sexual partners (푝 < 0.001). Conclusion. Behavioral and sociodemographic factors of vulnerability to HIV are predominant among men who have sex with men and/or are bisexual.

show abstract

Substance use in older HIV-infected patients

Cited by 37 publications

References 119 publications

Drug use among HIV+ adults aged 50 and older: findings from the GOLD II study

Drug use among HIV+ adults aged 50 and older: findings from the GOLD II study

A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians

Sociodemographic and Behavioral Factors Associated with HIV Vulnerability according to Sexual Orientation

Contact Info

Product

Resources

About