Erickson Adam, Becker Marissa, Shaw Souradet, Kasper Ken, Keynan Yoav
a Faculty of Medicine , University of Manitoba , Winnipeg , MB , Canada.
b Departments of Medicine, Medical Microbiology and Community Health Sciences, Centre for Global Public Health , University of Manitoba , Winnipeg , MB , Canada.
AIDS Care. 2015;27(9):1168-73. doi: 10.1080/09540121.2015.1035634. Epub 2015 May 1.
The high prevalence of substance use among HIV-infected individuals creates numerous challenges to patient care. This study was undertaken in order to understand the impact of substance use on care outcomes for HIV-infected individuals in Manitoba. Clinical records of 564 HIV-infected individuals in care at Health Sciences Centre in Winnipeg, Manitoba were reviewed. Clinical data were extracted from patient charts for substance users (illicit substance users, alcohol abusers and chronic users of opioids or benzodiazepines) and non-users. Substance users and non-users were analysed using chi-square analysis and logistic regression models to compare basic socio-demographic and clinic variables. Chi-square and analysis of variance were used to compare a subset of substance users based on similar socio-demographic and clinical characteristics. Among HIV-infected individuals in Manitoba, 38% were substance users with over-representation by Aboriginals, females, young adults and residents of Winnipeg's core areas. Opioids and benzodiazepines were the most commonly used substances with the majority of substance users having used multiple classes of substances in their lifetime. Substance users were more likely than non-users to have missed clinic appointments. Among substance users, missed appointments were more common among those who self-identified as Aboriginal, female, young adults, residents of Winnipeg's core areas, heterosexuals and those who had abused alcohol or cocaine/crack. Aboriginal substance users were also less likely to achieve viral load suppression compared to non-Aboriginal substance users. With the high prevalence of substance use among HIV-infected individuals in Manitoba, it is important to identify at-risk individuals in order to implement appropriate care strategies and improve treatment adherence and health outcomes.
在感染艾滋病毒的个体中，物质使用的高流行率给患者护理带来了诸多挑战。开展这项研究是为了了解物质使用对马尼托巴省感染艾滋病毒个体的护理结果的影响。对马尼托巴省温尼伯市健康科学中心接受护理的564名感染艾滋病毒个体的临床记录进行了审查。从患者病历中提取了物质使用者（非法药物使用者、酗酒者以及阿片类药物或苯二氮䓬类药物的长期使用者）和非使用者的临床数据。使用卡方分析和逻辑回归模型对物质使用者和非使用者进行分析，以比较基本的社会人口统计学和临床变量。使用卡方检验和方差分析，根据相似的社会人口统计学和临床特征对一部分物质使用者进行比较。在马尼托巴省感染艾滋病毒的个体中，38%是物质使用者，其中原住民、女性、年轻人以及温尼伯市核心区域的居民占比过高。阿片类药物和苯二氮䓬类药物是最常用的物质，大多数物质使用者一生中使用过多种类别的物质。物质使用者比非使用者更有可能错过门诊预约。在物质使用者中，自我认定为原住民、女性、年轻人、温尼伯市核心区域居民、异性恋者以及酗酒或滥用可卡因/快克的人错过预约的情况更为常见。与非原住民物质使用者相比，原住民物质使用者实现病毒载量抑制的可能性也较小。鉴于马尼托巴省感染艾滋病毒个体中物质使用的高流行率，识别高危个体以实施适当的护理策略并提高治疗依从性和健康结果非常重要。
