Health System-Based Unhealthy Alcohol Use Screening and Treatment Comparing Demographically Matched Participants With and Without HIV.
Health System-Based Unhealthy Alcohol Use Screening and Treatment Comparing Demographically Matched Participants With and Without HIV.
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DOI：
10.1111/acer.14481
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Satre DD
中科院分区：
文献类型：
--
作者：
Silverberg MJ;Levine-Hall T;Hood N;Anderson AN;Alexeeff SE;Lam JO;Slome SB;Flamm JA;Hare CB;Ross T;Justice AC;Sterne JAC;Williams AE;Bryant KJ;Weisner CM;Horberg MA;Sterling SA;Satre DD
HIV 感染者 (PLWH) 的不健康饮酒与显着的发病率有关，并且酒精服务的使用可能因 HIV 状况而异。我们的目标是根据初级保健中的艾滋病毒状况来比较不健康饮酒筛查和治疗。对成年（≥ 18 岁）艾滋病病毒感染者和未感染艾滋病毒的参与者进行的队列研究，按照年龄、性别和种族/民族与艾滋病病毒感染者进行 20:1 频率匹配，这些参与者参加了美国大型综合医疗保健系统，并从电子健康记录中确定了信息。结果包括不健康酒精筛查、患病率、提供者提供的简短干预措施和成瘾专业护理就诊。其他预测因素包括年龄、性别、种族/民族、邻里剥夺指数、抑郁、吸烟、物质使用障碍、查尔森合并症指数、既往门诊就诊、保险类型和医疗设施。 Cox 比例风险模型用于计算不健康饮酒筛查时间和首次成瘾专业就诊时间结果的风险比 (HR)。具有稳健标准误的泊松回归用于计算其他结果的患病率（HR）。包括 11,235 名艾滋病病毒感染者和 227,320 名未感染艾滋病毒的参与者。基线后 4.5 年，大多数参与者都接受了不健康饮酒筛查（85% 的 PLWH 和 93% 的 HIV 未感染者），但 PLWH 中的比例较低（调整后的风险比 [HR] 0.84，95% CI 0.82-0.85）。与未感染艾滋病毒的参与者相比，艾滋病病毒感染者在筛查者中报告不健康饮酒的可能性较小（调整后的 PR 0.74，95% CI 0.69-0.79），在筛查结果呈阳性的参与者中，接受简短干预的可能性较小（调整后的 PR 0.82，95% CI 0.75-0.90），但可能性更大（调整后的 HR 1.7，95% CI 0.75-0.90） 1.2–2.4) 在一年内进行成瘾专科就诊。感染者和艾滋病病毒感染者不健康饮酒的情况较低，但不同艾滋病毒感染状况的治疗方法有所不同。与未感染艾滋病毒的参与者相比，报告不健康饮酒的艾滋病病毒感染者接受的简短干预较少，接受的成瘾专业护理较多。
Unhealthy alcohol use among persons living with HIV (PLWH) is linked to significant morbidity and use of alcohol services may differ by HIV status. Our objective was to compare unhealthy alcohol use screening and treatment by HIV status in primary care. Cohort study of adult (≥18 years) PLWH and HIV-uninfected participants frequency-matched 20:1 to PLWH by age, sex, and race/ethnicity who were enrolled in a large integrated healthcare system in the United States, with information ascertained from an electronic health record. Outcomes included unhealthy alcohol screening, prevalence, provider-delivered brief interventions and addiction specialty care visits. Other predictors included age, sex, race/ethnicity, neighborhood deprivation index, depression, smoking, substance use disorders, Charlson comorbidity index, prior outpatient visits, insurance type, and medical facility. Cox proportional hazards models were used to compute hazard ratios (HR) for the outcomes of time to unhealthy alcohol use screening and time to first addiction specialty visit. Poisson regression with robust standard errors were used to compute prevalence ratios (HR) for other outcomes. 11,235 PLWH and 227,320 HIV-uninfected participants were included. By 4.5 years after baseline, most participants were screened for unhealthy alcohol use (85% of PLWH and 93% of HIV-uninfected), but with a lower rate among PLWH (adjusted hazard ratio [HR] 0.84, 95% CI 0.82–0.85). PLWH were less likely, compared with HIV-uninfected participants, to report unhealthy drinking among those screened (adjusted PR 0.74, 95% CI 0.69–0.79), and among those who screened positive, less likely to receive brief interventions (adjusted PR 0.82, 95% CI 0.75–0.90), but more likely (adjusted HR 1.7, 95% CI 1.2–2.4) to have an addiction specialty visit within one year. Unhealthy alcohol use was lower in PLWH, but the treatment approach by HIV status differed. PLWH reporting unhealthy alcohol use received less brief interventions and more addiction specialty care than HIV-uninfected participants.
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DOI：
10.1097/qad.0000000000000922
发表时间：
2016-01
期刊：
AIDS (London, England)
影响因子：
--
作者：
Park LS;Hernández-Ramírez RU;Silverberg MJ;Crothers K;Dubrow R
通讯作者：
Dubrow R
影响因子：
3.8
作者：
Bonacini, Maurizio
通讯作者：
Bonacini, Maurizio
DOI：
10.1097/qai.0b013e318142aabb
发表时间：
2007-10-01
影响因子：
3.6
作者：
Samet, Jeffrey H.;Cheng, Debbie M.;Saitz, Richard
通讯作者：
Saitz, Richard
影响因子：
4.4
作者：
Satre, Derek D.;Sarovar, Varada;Silverberg, Michael J.
通讯作者：
Silverberg, Michael J.
DOI：
10.1111/j.1530-0277.2010.01335.x
发表时间：
2011-02-01
影响因子：
3.2
作者：
DeLorenze, Gerald N.;Weisner, Constance;Quesenberry, Charles P., Jr.
通讯作者：
Quesenberry, Charles P., Jr.