Deren Sherry, Cortes Tara, Dickson Victoria Vaughan, Guilamo-Ramos Vincent, Han Benjamin H, Karpiak Stephen, Naegle Madeline, Ompad Danielle C, Wu Bei
Center for Drug Use and HIV Research, College of Global Public Health, New York University, New York, NY, United States.
Rory Meyers College of Nursing, New York University, New York, NY, United States.
Front Public Health. 2019 Apr 24;7:94. doi: 10.3389/fpubh.2019.00094. eCollection 2019.
Older people living with HIV (OPLWH) have higher rates of substance use (tobacco, alcohol, and other drugs) than their HIV-negative peers. Addressing health care needs of OPLWH who use substances is more challenging than for those who do not: they are highly impacted by comorbid conditions, substance use can interact with other medications (including antiretroviral therapy-ART) and reduce their effectiveness, and substance use has been associated with reduced adherence to ART and increased risky behaviors (including sexual risks). People who use substances also suffer disparities along the HIV continuum of care, resulting in lower viral suppression rates and poorer health outcomes. They are especially impacted by stigma and stress, which have implications for HIV treatment and care. Recommendations for health care providers working with OPLWH who use substances include: (1) the need to screen and refer for multiple associated conditions, and (2) training/continuing education to enhance care management and maximize health outcomes.
与未感染艾滋病毒的同龄人相比，感染艾滋病毒的老年人（OPLWH）使用物质（烟草、酒精和其他毒品）的比例更高。满足使用物质的OPLWH的医疗需求比不使用物质的人更具挑战性：他们受到合并症的严重影响，物质使用会与其他药物（包括抗逆转录病毒疗法-ART）相互作用并降低其有效性，并且物质使用与抗逆转录病毒疗法依从性降低和危险行为增加（包括性风险）有关。使用物质的人在艾滋病毒连续护理过程中也存在差异，导致病毒抑制率较低和健康结果较差。他们尤其受到耻辱感和压力的影响，这对艾滋病毒治疗和护理有影响。针对与使用物质的OPLWH合作的医疗保健提供者的建议包括：（1）需要筛查并转诊多种相关疾病，以及（2）进行培训/继续教育以加强护理管理并最大限度地提高健康结果。
