Hazardous alcohol use, antiretroviral therapy receipt, and viral suppression in people living with HIV who inject drugs in the United States, India, Russia, and Vietnam.
AIDS
; 34(15): 2285-2294, 2020 12 01.
Article
em En
| MEDLINE
| ID: mdl-33048870
ABSTRACT
OBJECTIVES:
In high-income countries, hazardous alcohol use is associated with reduced receipt of antiretroviral therapy (ART) and viral suppression among people living with HIV (PLHIV) who inject drugs. These associations are less understood in lower middle-income countries (LMIC) and upper middle-income countries.DESIGN:
We examined associations between hazardous alcohol use, ART receipt, and viral suppression among PLHIV who reported current or former injection drug use. Participants were from nine studies in the United States (high-income country), India (LMIC), Russia (upper middle-income country), and Vietnam (LMIC).METHODS:
Hazardous alcohol use was measured via Alcohol Use Disorders Identification Test. Outcomes were HIV viral suppression (viral load of <1000 RNA copies/ml) and self-reported ART receipt. Logistic regression assessed associations between hazardous alcohol use and both outcome variables, controlling for age and sex, among participants with current and former injection drug use.RESULTS:
Among 2790 participants, 16% were women, mean age was 37.1â±â9.5 years. Mean Alcohol Use Disorders Identification Test scores were 4.6â±â8.1 (women) and 6.2â±â8.3 (men); 42% reported ART receipt; 40% had viral suppression. Hazardous alcohol use was significantly associated with reduced ART receipt in India (adjusted odds ratioâ=â0.59, 95% confidence interval 0.45-0.77, Pâ<â0.001); and lower rates of viral suppression in Vietnam (adjusted odds ratioâ=â0.51, 95% confidence interval 0.31-0.82, Pâ=â0.006).CONCLUSION:
Associations between hazardous alcohol use, ART receipt, and viral suppression varied across settings and were strongest in LMICs. Addressing hazardous alcohol use holds promise for improving HIV continuum of care outcomes among PLHIV who inject drugs. Specific impact and intervention needs may differ by setting.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Abuso de Substâncias por Via Intravenosa
/
Transtornos Relacionados ao Uso de Álcool
/
Antirretrovirais
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
/
Asia
/
Europa
Idioma:
En
Revista:
AIDS
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos