Opioid Misuse Among HIV-Positive Adults in Medical Care: Results From the Medical Monitoring Project, 2009-2014.
Opioid Misuse Among HIV-Positive Adults in Medical Care: Results From the Medical Monitoring Project, 2009-2014.
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DOI：
10.1097/qai.0000000000001889
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发表时间：
2019-02-01
期刊：
影响因子：
--
通讯作者：
Beer L
中科院分区：
文献类型：
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作者：
Lemons A;DeGroote N;Peréz A;Craw J;Nyaku M;Broz D;Mattson CL;Beer L
艾滋病毒感染者比未感染艾滋病毒的人更经常和更高剂量地服用阿片类药物，并且不成比例地经历药物使用障碍的风险因素，这表明他们滥用阿片类药物的风险可能增加。研究人员还认为，阿片类药物滥用对各种艾滋病毒临床结果产生负面影响，增加了传播给艾滋病毒阴性伴侣的风险。我们计算了加权百分比和95%置信区间，以估计在美国接受医疗护理的28，162名滥用阿片类药物的HIV阳性成年人（n = 975）的概率样本中的物质使用特征。然后，我们使用Rao-Scott χ2检验来评估阿片类药物滥用与选定特征之间的双变量关联。总的来说，3.3%滥用阿片类药物。滥用在年轻人、男性和非西班牙裔白人中更为常见。滥用阿片类药物的人不太可能：已处方抗逆转录病毒治疗（ART）（88.7%），报告在过去3天内坚持ART药物治疗（78.1%），并具有持久的病毒抑制（54.3%）比没有滥用阿片类药物的人（分别为92.5%，87.7%和64.7%）。滥用阿片类药物的人更有可能报告与阴性或未知HIV状态的伴侣发生无避孕套性行为，而不是持久的病毒抑制（11.7% vs 3.4%）。接受艾滋病毒医疗护理的成年人滥用阿片类药物与抗逆转录病毒治疗依从性不足、持久病毒抑制不足以及艾滋病毒传播给性伴侣的风险较高有关。
People living with HIV are prescribed opioids more often and at higher doses than people who do not have HIV, and disproportionately experience risk factors for substance use disorder, which suggests they could be at increased risk of the misuse of opioids. Researchers also suggest that opioid misuse negatively affects various HIV clinical outcomes, increasing the risk of transmission to partners with an HIV-negative status. We calculated weighted percentages and 95% confidence intervals to estimate substance use characteristics among a probability sample of 28,162 HIV-positive adults receiving medical care in the United States who misused opioids (n = 975). Then, we used Rao-Scott χ2 tests to assess bivariate associations between opioid misuse and selected characteristics. In all, 3.3% misused opioids. Misuse was more common among young adults, males, and non-Hispanic whites. Persons who misused opioids were less likely to: have been prescribed antiretroviral therapy (ART) (88.7%), report being adherent to ART medications in the past 3 days (78.1%), and have durable viral suppression (54.3%) than persons who did not misuse opioids (92.5%, 87.7%, and 64.7%, respectively). Persons who misused opioids were more likely to report condomless sex with partners of negative or unknown HIV status while not durably virally suppressed (11.7% vs 3.4%) than persons who did not misuse opioids. Opioid misuse among adults receiving HIV medical care is associated with inadequate ART adherence, insufficient durable viral suppression, and higher risk of HIV transmission to sexual partners.