This article is more than 5 years old. Information may no longer be current.
Multiple risky behaviors commonly occur among people with HIV
Click Here to Manage Email Alerts
Substance use, unprotected sex and nonadherence to medication are common among people with HIV who are engaged in primary care, and these issues need to be addressed in prevention programs, researchers reported in American Journal of Public Health.
“The co-occurrence of these conditions could attenuate the public health benefits of test, treat and linkage to care strategies, which are predicated on the assumption that if more HIV-infected people are tested and enrolled in care, treatment will decrease the community viral load,” Matthew J. Mimiaga, ScD, MPH, assistant professor at Harvard Medical School and Harvard School of Public Health, told Infectious Disease News.
Matthew J. Mimiaga
Mimiaga and colleagues used data from the Centers for AIDS Research Network of Integrated Clinical Systems study cohort to evaluate substance use behaviors and health consequences among people with HIV. The study included 3,413 patients from four cities. The majority of the participants were men (84%) and almost half (46.2%) were in minority racial/ethnic groups.
Although 76.7% of the patients were receiving ART at the time of the study, only 30.6% of these were being fully adherent to the regimen. More than one-third of the group reporting engaging in anal sex in the past 6 months, and more than half of these reported engaging in unprotected sex. Among the 19% of patients who reported engaging in vaginal sex in the previous 6 months, 46% reported engaging in unprotected sex.
In the previous 3 months, 24.3% reported using marijuana, 9% used amphetamines, 8.5% used crack-cocaine, 2.8% used injection drugs and 2% used opiates. In a multivariable analysis, medication nonadherence was associated with all substance use except for marijuana. Unprotected anal sex was associated with marijuana, amphetamine, injection drug and polydrug use. A higher number of vaginal sex partners was associated with polydrug and crack-cocaine use. Other factors associated with substance use included detectable viral load, depression and anxiety.
“These data are consistent with previous research documenting the potential deleterious health consequences of substance use among people living with HIV,” Mimiaga said. “Our results support regular screening for nonparenteral and parenteral drug use in primary care settings where HIV-infected patients are treated. Specifically, they support US Public Health Service guidelines that focus on the need for comprehensive HIV-related care that incorporates screening for substance use and mental health as well as referrals to tertiary services.”
Matthew Mimiaga, ScD, MPH, can be reached at mmimiaga@partners.org.
Disclosure: Mimiaga reports no relevant financial disclosures.
Click Here to Manage Email Alerts