Montoya Jessica L, Cattie Jordan, Morgan Erin, Woods Steven Paul, Cherner Mariana, Moore David J, Atkinson J Hampton, Grant Igor
a Clinical Psychology, San Diego State University/University of California, San Diego Joint Doctoral Program , San Diego , CA , USA.
b Translational Methamphetamine AIDS Research Center, Department of Psychiatry , School of Medicine, University of California, San Diego , La Jolla , CA , USA.
Am J Drug Alcohol Abuse. 2016 Mar;42(2):168-77. doi: 10.3109/00952990.2015.1114625. Epub 2016 Feb 2.
Characterizing methamphetamine use in relation to age, HIV serostatus and seroconversion is pertinent given the increasingly older age of the population with HIV and the intertwined epidemics of methamphetamine use and HIV.
Study aims were to investigate whether (i) methamphetamine use differs by age and HIV serostatus, and (ii) receiving an HIV diagnosis impacts methamphetamine use among younger and older persons with HIV.
This study examined methamphetamine use characteristics among 217 individuals with a lifetime methamphetamine dependence diagnosis who completed an in-person study assessment.
Multivariable regressions revealed that HIV serostatus uniquely attenuates methamphetamine use, such that persons with HIV report a smaller cumulative quantity (β = -0.16, p = 0.01) and a fewer number of days (β = -0.18, p = 0.004) of methamphetamine use than persons without HIV. Among the HIV+ sample, all participants persisted in methamphetamine use after receiving an HIV diagnosis, with about 20% initiating use after seroconversion. Repeated measures analysis of variance indicated that density of methamphetamine use (i.e. grams per day used) was greater among the younger, relative to the older, HIV+ group (p = 0.02), and increased for both age groups following seroconversion (p < 0.001).
These analyses indicate that although HIV serostatus may attenuate methamphetamine use behaviors, many people with HIV initiate, or persist in, methamphetamine use after receiving an HIV diagnosis. These findings raise the question of whether tailoring of prevention and intervention strategies might reduce the impact of methamphetamine and HIV across the age continuum.
鉴于感染艾滋病毒的人群年龄日益增大,以及甲基苯丙胺使用与艾滋病毒疫情相互交织,描述甲基苯丙胺使用与年龄、艾滋病毒血清学状态及血清转化之间的关系至关重要。
研究目的是调查:(i)甲基苯丙胺使用情况是否因年龄和艾滋病毒血清学状态而异;(ii)接受艾滋病毒诊断对感染艾滋病毒的年轻人和老年人的甲基苯丙胺使用有何影响。
本研究对217名有终生甲基苯丙胺依赖诊断且完成了现场研究评估的个体的甲基苯丙胺使用特征进行了检查。
多变量回归显示,艾滋病毒血清学状态独特地减弱了甲基苯丙胺的使用,即感染艾滋病毒的人报告的甲基苯丙胺累积使用量(β = -0.16,p = 0.01)和使用天数(β = -0.18,p = 0.004)均少于未感染艾滋病毒的人。在艾滋病毒阳性样本中,所有参与者在接受艾滋病毒诊断后仍持续使用甲基苯丙胺,约20%的人在血清转化后开始使用。重复测量方差分析表明,相对于年龄较大的艾滋病毒阳性组,年龄较小的艾滋病毒阳性组甲基苯丙胺的使用密度(即每天使用的克数)更高(p = 0.02),且血清转化后两个年龄组的使用密度均增加(p < 0.001)。
这些分析表明,尽管艾滋病毒血清学状态可能会减弱甲基苯丙胺的使用行为,但许多感染艾滋病毒的人在接受艾滋病毒诊断后仍开始或持续使用甲基苯丙胺。这些发现提出了一个问题,即调整预防和干预策略是否可能减少甲基苯丙胺和艾滋病毒在整个年龄范围内的影响。