Friedman Mark S, Marshal Michael P, Stall Ron, Kidder Daniel P, Henny Kirk D, Courtenay-Quirk Cari, Wolitski Richard J, Aidala Angela, Royal Scott, Holtgrave David R
Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, USA.
AIDS Care. 2009 Jun;21(6):692-700. doi: 10.1080/09540120802513709.
Prior research suggests that the interconnections between substance use, HIV risk and lack of adherence to HIV medications are especially strong among homeless individuals. Thus, study of these interconnections warrants public health attention. The objectives of this paper are to describe patterns of alcohol and drug use, associations between substance use and participation in high-risk sex, and associations between substance use and adherence to HIV treatment regimens among a sample of 602 homeless or unstably housed HIV-seropositive individuals who are part of a housing-based intervention--the Housing and Health Study. Participants experienced high levels of substance use. Significant associations were found between substance use and adherence to HIV treatment medications, and between substance use and high-risk sexual practices within the entire group. Group analyses by sexual orientation/gender show that the association between substance use and treatment adherence is found primarily among heterosexual males whereas the relationship between several drugs and high-risk sexual practices is strongest among gay and bisexual men. Health professionals working with HIV-seropositive individuals should routinely ascertain housing status and screen for substance use and risky sex.
先前的研究表明，在无家可归者中，物质使用、感染艾滋病毒风险以及不坚持服用抗艾滋病毒药物之间的相互联系尤为紧密。因此，对这些相互联系的研究值得公共卫生领域关注。本文的目的是描述602名无家可归或居住不稳定的艾滋病毒血清呈阳性个体的酒精和药物使用模式、物质使用与参与高危性行为之间的关联，以及物质使用与坚持艾滋病毒治疗方案之间的关联，这些个体是一项基于住房的干预措施——住房与健康研究的一部分。参与者的物质使用水平较高。在整个群体中，发现物质使用与坚持服用艾滋病毒治疗药物之间存在显著关联，物质使用与高危性行为之间也存在显著关联。按性取向/性别进行的分组分析表明，物质使用与治疗依从性之间的关联主要在异性恋男性中发现，而几种药物与高危性行为之间的关系在男同性恋者和双性恋男性中最为明显。与艾滋病毒血清呈阳性个体打交道的卫生专业人员应常规确定其住房状况，并筛查物质使用情况和危险性行为。
