Abstract
BackgroundInformation regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage.MethodsWe examined the effect of specific substances on stage of HIV disease at entry into care in over 5000 persons with HIV (PWH) newly enrolling in care. Substance use was obtained from the AUDIT-C and ASSIST instruments. We examined the association between early entry into care and substance use (high-risk alcohol, methamphetamine, cocaine/crack, illicit opioids, marijuana) using logistic and relative risk regression models adjusting for demographic factors, mental health symptoms and diagnoses, and clinical site.ResultsWe found that current methamphetamine use, past and current cocaine and marijuana use was associated with earlier entry into care compared with individuals who reported no use of these substances.ConclusionEarly entry into care among those with substance use suggests that HIV testing may be differentially offered to people with known HIV risk factors, and that individuals with substances use disorders may be more likely to be tested and linked to care due to increased interactions with the healthcare system.
Highlights
Information regarding the impact of substance use on the timing of entry into HIV care is lacking
Mental health diagnoses and past or current substance use were more prevalent than reported within the general United States (US) population [36]
In the single substance models, we found a significant association between current methamphetamine use (OR = 1.52, 95% Confidence Interval (CI): 1.23–1.88; RR = 1.14, 95% CI: 1.07–1.22), as well as past and current cocaine and past and current marijuana use (ORs = 1.20, 1.43, 1.19, 1.33, respectively; RRs = 1.07, 1.13, 1.07, 1.12) and increased likelihood of early entry into care (CD4 count > 350 cells/mm3) compared with people with HIV (PWH) who reported no use of those substances
Summary
Information regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage. Diagnosis and engagement in care are key to maximizing the benefit of ART, minimizing the long-term negative consequences of HIV, and the success of a treatment as prevention approach [3,4,5]. In the United States (US), it is estimated that only 86% of people with HIV (PWH) have been diagnosed, and only 64% have been linked to care [6] These proportions change over time, they are well below national and international HIV targets [2]. Research is needed to better define the challenges and optimal approaches to improve care delivery to individuals with co-occurring substance use
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
