EFFECTS OF HAZARDOUS ALCOHOL AND DRUG USE ON ANTIRETROVIRAL ADHERENCE AND HIV VIRAL SUPPRESSION: A MEDIATION ANALYSIS

Abstract Background: Little is known regarding the degree to which substance and alcohol use effects on HIV viral suppression are mediated through medication adherence. We hypothesized that the total effects of such use are mediated through adherence. Methods: We included patients with HIV (PWH) receiving care at an urban academic HIV clinic between 2014 and 2018. Eligible patients were those prescribed antiretroviral therapy who completed both patient reported outcome (PRO) questionnaires, and had subsequent plasma viral load (pVL) measurements. Measures included assessments of alcohol use (AUDIT-C), drug use (ASSIST), and self-reported adherence. Substances found in bivariate analysis to predict detectable pVL were modeled separately for mediation effects through adherence. We report natural direct (NDE) and indirect effect (NIE), marginal total effect (MTE) and percentage mediated. Results: Among 3125 Patients who met eligibility criteria, percentages of current use by category were: hazardous alcohol 25.8%, cannabis 27.1%, amphetamines 13.1%, inhalants 11.9%, cocaine 5.3%, sedative-hypnotics 4.5%, opioids 2.9%, and hallucinogens 2.3%. Excellent adherence was reported in 58% and 10% had detectable pVL. Except for sedatives use of other ascertained substances was significantly associated with worse adherence. Bivariate predictors of detectable pVL were [OR(95% CI)]: amphetamine use 2.4 (1.8 -3.2 ) and opioid use 2.3 (1.3 - 4.0) . The percentage mediated by adherence was 36% for amphetamine use, 26.5% for opioid use, and 39% for multiple substance use. Conclusion: Use of amphetamines, opioids, and multiple substances predicted detectable pVL. However, less than 40% of effects were mediated by self-reported adherence.

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P.0315 Association between hazardous alcohol use and initiation of naltrexone treatment for opioid use disorder among hiv-positive persons in russia

European Neuropsychopharmacology ◽

10.1016/j.euroneuro.2021.10.298 ◽

2021 ◽

Vol 53 ◽

pp. S228-S229

Author(s):

M. Vetrova ◽

E.A. Blokhina ◽

D.M. Cheng ◽

V. Truong ◽

E.K. Quinn ◽

...

Keyword(s):

Alcohol Use ◽

Opioid Use Disorder ◽

Hiv Positive ◽

Opioid Use ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

Naltrexone Treatment

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Effect of 2 Integrated Interventions on Alcohol Abstinence and Viral Suppression Among Vietnamese Adults With Hazardous Alcohol Use and HIV

JAMA Network Open ◽

10.1001/jamanetworkopen.2020.17115 ◽

2020 ◽

Vol 3 (9) ◽

pp. e2017115 ◽

Cited By ~ 4

Author(s):

Vivian F. Go ◽

Heidi E. Hutton ◽

Tran V. Ha ◽

Geetanjali Chander ◽

Carl A. Latkin ◽

...

Keyword(s):

Alcohol Use ◽

Viral Suppression ◽

Hazardous Alcohol Use ◽

Alcohol Abstinence ◽

Hazardous Alcohol

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Hazardous Alcohol Use, Impulsivity, and HIV‐Risk Behavior Among HIV‐Positive Russian Patients With a History of Injection Drug Use

American Journal on Addictions ◽

10.1111/ajad.13112 ◽

2020 ◽

Author(s):

Kathryn Chavez ◽

Tibor P. Palfai ◽

Debbie M. Cheng ◽

Elena Blokhina ◽

Natalia Gnatienko ◽

...

Keyword(s):

Alcohol Use ◽

Drug Use ◽

Risk Behavior ◽

Injection Drug Use ◽

Hiv Risk ◽

Hiv Risk Behavior ◽

Hiv Positive ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

History Of

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Impact of co-occurring drug use, hazardous alcohol use and mental health disorders on drug use patterns in people living with HIV and hepatitis C virus infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab520 ◽

2021 ◽

Author(s):

Sean McCormick ◽

Kathleen M Ward ◽

Catherine G Sutcliffe ◽

Risha Irvin ◽

Geetanjali Chander ◽

...

Keyword(s):

Mental Health ◽

Alcohol Use ◽

Drug Use ◽

Mental Health Disorders ◽

People Living With Hiv ◽

Hazardous Alcohol Use ◽

Use Patterns ◽

Hazardous Alcohol ◽

Health Disorders ◽

Living With Hiv

Abstract Drug use, hazardous alcohol use, and mental health disorders are prevalent among people with HIV and HCV infection. Co-occurrence of alcohol use and depression negatively impacts substance use patterns. Nevertheless, HCV treatment provides a promising opportunity to identify and address co-occurring drug use, hazardous alcohol use, and mental health disorders.

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Mental Symptoms and Drug Use in Maintenance Treatment with Slow-Release Oral Morphine Compared to Methadone: Results of a Randomized Crossover Study

European Addiction Research ◽

10.1159/000368572 ◽

2014 ◽

Vol 21 (2) ◽

pp. 97-104 ◽

Cited By ~ 17

Author(s):

Uwe Verthein ◽

Thilo Beck ◽

Christian Haasen ◽

Jens Reimer

Keyword(s):

Alcohol Use ◽

Drug Use ◽

Treatment Satisfaction ◽

Maintenance Treatment ◽

Slow Release ◽

Oral Morphine ◽

Open Label ◽

Positive Effects ◽

Patient Reported ◽

Mental Symptoms

Background: Opioid maintenance treatment is the option of choice to stabilize opioid-dependent patients. Whilst efficacy of methadone and buprenorphine has been studied extensively, fewer data on slow-release oral morphine are available. Aims: This study analyzes the effects of slow-release oral morphine compared to methadone with regard to self-reported mental symptoms, drug use and satisfaction with treatment. Methods: The study was carried out as an open-label randomized crossover trial in 14 treatment sites in Switzerland and Germany. It comprised 2 crossover periods of 11 weeks each. For measuring mental symptoms, the Symptom Checklist-27 (SCL-27) was used. Drug and alcohol use was assessed by the number of consumption days, and treatment satisfaction by a visual analogue scale. Results: A total of 157 patients were included for the analyses (per-protocol sample). Statistically significantly better outcomes for morphine as compared to methadone treatment were found for overall severity of mental symptoms (SCL-27 Global Severity Index), as well as 5 of the 6 syndrome groups of the SCL-27, and for treatment satisfaction. There were no statistically significant differences with regard to drug or alcohol use between groups. Conclusions: This study supports positive effects of slow-release oral morphine compared to methadone on patient-reported outcomes such as mental symptoms and treatment satisfaction with comparable effects on concomitant drug use. Slow-release oral morphine represents a meaningful alternative to methadone for treatment of opioid dependence.

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Drug use in college students: a 13-year trend

Revista de Saúde Pública ◽

10.1590/s0034-89102012005000033 ◽

2012 ◽

Vol 46 (3) ◽

pp. 497-504 ◽

Cited By ~ 11

Author(s):

Gabriela Arantes Wagner ◽

Lúcio Garcia de Oliveira ◽

Lucia Pereira Barroso ◽

Raphael Nishimura ◽

Luciana Morita Ishihara ◽

...

Keyword(s):

College Students ◽

Alcohol Use ◽

Drug Use ◽

Multiple Comparisons ◽

Southeastern Brazil ◽

Bonferroni Correction ◽

Cross Sectional ◽

Amphetamine Use ◽

The City ◽

Self Administered Questionnaire

OBJECTIVE: To analyze drug use trends among college students in 1996, 2001 and 2009. METHODS: A cross-sectional epidemiological study with a multistage stratified cluster sample with 9,974 college students was conducted in the city of São Paulo, southeastern Brazil. An anonymous self-administered questionnaire was used to collect information on drug use assessed in lifetime, the preceding 12 months and the preceding 30 days. The Bonferroni correction was used for multiple comparisons of drug use rates between surveys. RESULTS: There were changes in the lifetime use of tobacco and some other drugs (hallucinogens [6.1% to 8.8%], amphetamines [4.6% to 8.7%], and tranquilizers [5.7% to 8.2%]) from 1996 to 2009. Differences in the use of other drugs over the 12 months preceding the survey were also seen: reduced use of inhalants [9.0% to 4.8%] and increased use of amphetamines [2.4% to 4.8%]. There was a reduction in alcohol [72.9% to 62.1%], tobacco [21.3% to 17.2%] and marijuana [15.0% to 11.5%] use and an increase in amphetamine use [1.9% to 3.3%] in the preceeding 30 days. CONCLUSIONS: Over the 13-year study period, there was an increase in lifetime use of tobacco, hallucinogens, amphetamines, and tranquilizers. There was an increase in amphetamine use and a reduction in alcohol use during the preceding 12 months. There was an increase in amphetamine use during the preceding 30 days.

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Urine Screening for Opiod and Illicit Drugs in the Total Joint Arthroplasty Population

Kansas Journal of Medicine ◽

10.17161/kjm.v13i1.13623 ◽

2020 ◽

Vol 13 (1) ◽

pp. 71-76 ◽

Cited By ~ 1

Author(s):

Matthew Vopat ◽

William Messamore ◽

Jesse Trent ◽

Ken Schmanke ◽

Rosey Zackula ◽

...

Keyword(s):

Drug Use ◽

Illicit Drugs ◽

Illicit Drug ◽

Illicit Drug Use ◽

Joint Arthroplasty ◽

Prescription Opioid ◽

Opioid Use ◽

Number Of Patients ◽

Patient Reported ◽

History Of

Introduction. Recent studies have shown an increase in post-operative orthopaedic complications associated with pre-operative opioid use. It is, therefore, important to know if patients use opioids before scheduled surgery. The purpose of this study was to determine if urine drug screening (UDS) is an effective screening tool for detecting opioid and illicit drug use prior to joint arthroplasty (JA) procedures. Methods. This retrospective chart review was performed with IRB approval on 166 out of 172 consecutive patients in a community-based practice. All the patients had a pre-operative UDS prior to primary or revision JA by a fellowship trained orthopaedic surgeon between March 2016 and April 2017. Patient demographics documented opioid and illicit drug use, co-morbid diagnosis, and UDS results were collected from clinical charts. Statistical analysis was conducted using Pearson Chi-square, Fisher’s exact, McNemar test, and t-tests with IBM SPSS Statistics, ver. 23. Significant differences were p < 0.05. Results. Sixty-four of 166 patients (38.6%) tested positive for opioids. Among them, 55.0% (35/64) had no history of prescription opioid use. Significant differences were observed when comparing the test results of the UDS with the patient reported history of prescribed opioids (p = 0.001). Conclusion. With a significant number of patients testing positive for opioids without evidence of a previous prescription, UDS may be beneficial for initial risk assessment for patients undergoing JA procedures.

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A Systematic Review and Meta-Analysis of Studies Evaluating the Effect of Medication Treatment for Opioid Use Disorder on Infectious Disease Outcomes

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab289 ◽

2021 ◽

Author(s):

Katelyn F McNamara ◽

Breanne E Biondi ◽

Raúl U Hernández-Ramírez ◽

Noor Taweh ◽

Alyssa A Grimshaw ◽

...

Keyword(s):

Infectious Disease ◽

Sustained Virologic Response ◽

Viral Suppression ◽

Meta Analysis ◽

Virologic Response ◽

Opioid Use Disorder ◽

Art Adherence ◽

Opioid Use ◽

Disease Outcomes ◽

Hiv Viral Suppression

Abstract The opioid epidemic has fueled infectious disease epidemics. We determined the impact of medications for opioid use disorder (OUD; MOUD) on treatment outcomes of OUD-associated infectious diseases: antiretroviral therapy (ART) adherence, HIV viral suppression, hepatitis C (HCV) sustained virologic response, HCV re-infection, new HBV infections, and infectious endocarditis-related outcomes. Manuscripts reporting on these infectious disease outcomes in adults with OUD receiving MOUD compared with those with OUD not receiving MOUD were included. Initial search yielded 8,169 papers; 9 were included in the final review. The meta-analysis revealed that MOUD was associated with greater ART adherence (OR=1.55; 95%CI=1.12-2.15) and HIV viral suppression (2.19; 1.88-2.56). One study suggested a positive association between MOUD and HCV sustained virologic response. There is significant support for integrating MOUD with HIV treatment to improve viral suppression among persons with HIV (PWH) and OUD. Treatment of OUD among PWH should be a priority in order to combat the opioid and HIV epidemics.

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