Division of Pediatric Infectious Diseases, Department of Pediatrics, Duke University School of Medicine, 2 Genome Court, DUMC Box 103020, Durham, NC, 27710, USA.
Division of Pediatric Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
AIDS Behav. 2018 Apr;22(4):1363-1372. doi: 10.1007/s10461-017-1961-9.
There is a paucity of data regarding the impact of drug use on HIV suppression and care retention among adolescents and young adults (AYAs). We recruited a clinic-based sample of HIV infected AYAs to assess the prevalence of self-reported drug use. Clinical data, including retention and viral suppression, were abstracted from the electronic medical record. Logistic regression was used to evaluate marijuana and illicit drug use associations and to identify other risk factors. Of 200 participants (mean age 21, 2.4 years, 69% horizontally infected), 46% reported current drug use, with marijuana as the most commonly used drug. Any illicit drug use (aOR 1.99, 95% CI 1.06-3.73, p = 0.032) and lower education (aOR 2.11, 95% CI 1.09-4.08, p = 0.046) were associated with poor viral suppression in multivariable analyses. Considering marijuana use only, an association with poor viral suppression was more pronounced (aOR 2.10, 95% CI 1.12-3.94, p = 0.021). Drug use did not have a significant association with retention in care, but AYAs who were retained in HIV care were less likely to have poorly suppressed HIV (aOR 0.22, 95% CI 0.10-0.49, p < 0.001). High prevalence of marijuana use among HIV infected AYAs, and its association with poorly suppressed HIV, demonstrates the need for intervention strategies to decrease its consumption.
关于药物使用对青少年和年轻成年人（AYA）的 HIV 抑制和护理保留的影响，数据很少。我们招募了一个以诊所为基础的 HIV 感染 AYA 样本，以评估自我报告的药物使用流行率。从电子病历中提取临床数据，包括保留和病毒抑制。使用逻辑回归评估大麻和非法药物使用的关联，并确定其他危险因素。在 200 名参与者（平均年龄 21 岁，2.4 年，69%水平感染）中，46%报告目前有药物使用，大麻是最常用的药物。任何非法药物使用（aOR 1.99，95%CI 1.06-3.73，p=0.032）和较低的教育程度（aOR 2.11，95%CI 1.09-4.08，p=0.046）与多变量分析中的病毒抑制不良相关。仅考虑大麻使用，与病毒抑制不良的关联更为明显（aOR 2.10，95%CI 1.12-3.94，p=0.021）。药物使用与护理保留没有显著关联，但保留在 HIV 护理中的 AYA 更不可能 HIV 抑制不良（aOR 0.22，95%CI 0.10-0.49，p<0.001）。HIV 感染 AYA 中大麻使用的高流行率及其与病毒抑制不良的关联表明，需要采取干预策略来减少其使用。
