Parrish Canada, Whitney Bridget M, Nance Robin M, Puttkammer Nancy, Fishman Paul, Christopoulos Katerina, Fleming Julia, Heath Sonya, Mathews William Christopher, Chander Geetanjali, Moore Richard D, Napravnik Sonia, Webel Allison, Delaney Joseph, Crane Heidi M, Kitahata Mari M
University of Washington, 1705 NE Pacific Street, Seattle, WA, 98195, USA.
University of California San Francisco, San Francisco, CA, USA.
Arch Public Health. 2021 Aug 28;79(1):153. doi: 10.1186/s13690-021-00677-2.
Information regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage.
We examined the effect of specific substances on stage of HIV disease at entry into care in over 5000 persons with HIV (PWH) newly enrolling in care. Substance use was obtained from the AUDIT-C and ASSIST instruments. We examined the association between early entry into care and substance use (high-risk alcohol, methamphetamine, cocaine/crack, illicit opioids, marijuana) using logistic and relative risk regression models adjusting for demographic factors, mental health symptoms and diagnoses, and clinical site.
We found that current methamphetamine use, past and current cocaine and marijuana use was associated with earlier entry into care compared with individuals who reported no use of these substances.
Early entry into care among those with substance use suggests that HIV testing may be differentially offered to people with known HIV risk factors, and that individuals with substances use disorders may be more likely to be tested and linked to care due to increased interactions with the healthcare system.
关于物质使用对进入艾滋病护理时机的影响的信息尚缺。更好地理解这种关系有助于指导改善艾滋病检测及关联的方法和政策。
我们研究了特定物质对5000多名新进入护理的艾滋病毒感染者（PWH）进入护理时的艾滋病疾病阶段的影响。物质使用情况通过酒精使用障碍识别测试简版（AUDIT-C）和药物使用筛查工具（ASSIST）获得。我们使用逻辑回归和相对风险回归模型，在调整人口统计学因素、心理健康症状和诊断以及临床地点后，研究早期进入护理与物质使用（高危酒精、甲基苯丙胺、可卡因/快克、非法阿片类药物、大麻）之间的关联。
我们发现，与报告未使用这些物质的个体相比，当前使用甲基苯丙胺、过去和当前使用可卡因及大麻与更早进入护理有关。
有物质使用问题者早期进入护理表明，可能会向已知有艾滋病毒风险因素的人提供不同的艾滋病检测，并且由于与医疗保健系统的互动增加，有物质使用障碍的个体可能更有可能接受检测并与护理建立关联。
