Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue NW, Washington, DC, 20052, USA.
District of Columbia Department of Health, HIV/AIDS, Hepatitis, STD and TB Administration, 950 New Hampshire Avenue NW, Washington, DC, 20052, USA.
AIDS Behav. 2021 Jul;25(7):2289-2300. doi: 10.1007/s10461-021-03157-4. Epub 2021 Feb 1.
Substance use disorders (SUDs) are common among people with HIV and can prevent achievement of optimal health outcomes. Using data from a longitudinal HIV cohort study in the District of Columbia (2011-2018), we calculated the prevalence and correlates of SUD (alcohol, stimulant, and/or opioid use disorders) and determined the association of SUD with engagement in HIV care, ART prescription, viral suppression, and mortality. Of 8420 adults, 3168 (37.6%) had a history of any SUD, most commonly history of alcohol use disorder (29.6%). SUDs disproportionately affected Black individuals (aOR 1.33) and heterosexuals (aOR 1.18), and women had a lower risk of SUD (aOR 0.65). SUD was not associated with engagement in care, ART prescription, or viral suppression. SUD was associated with mortality (aHR 1.31). Addressing alcohol use disorder and preventable causes of death among people with HIV and substance use disorders should be priorities for clinical care and public health.
物质使用障碍（SUDs）在 HIV 感染者中很常见，可能会妨碍他们实现最佳健康结果。我们利用哥伦比亚特区（2011-2018 年）一项 HIV 纵向队列研究的数据，计算了 SUD（酒精、兴奋剂和/或阿片类物质使用障碍）的流行率及其相关因素，并确定了 SUD 与 HIV 护理参与、ART 处方、病毒抑制和死亡率之间的关联。在 8420 名成年人中，3168 人（37.6%）有 SUD 史，最常见的是酒精使用障碍史（29.6%）。SUD 更易影响黑人和异性恋者（aOR 1.33 和 1.18），女性 SUD 风险较低（aOR 0.65）。SUD 与护理参与、ART 处方或病毒抑制无关。SUD 与死亡率相关（aHR 1.31）。解决 HIV 感染者和物质使用障碍者中的酒精使用障碍和可预防的死亡原因应成为临床护理和公共卫生的优先事项。
