Residential Eviction and Risk of Detectable Plasma HIV-1 RNA Viral Load Among HIV-Positive People Who Use Drugs.
Residential Eviction and Risk of Detectable Plasma HIV-1 RNA Viral Load Among HIV-Positive People Who Use Drugs.
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DOI：
10.1007/s10461-016-1315-z
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发表时间：
2017-03
影响因子：
4.4
通讯作者：
Milloy MJ
中科院分区：
文献类型：
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作者：
Kennedy MC;Kerr T;McNeil R;Parashar S;Montaner J;Wood E;Milloy MJ
我们在加拿大温哥华的一组接受抗逆转录病毒治疗（ART）的hiv血清阳性使用非法药物（PWUD）的人群中研究了迁出住宅与血浆HIV-1 RNA病毒载量（VL）检测之间的关系。我们使用多变量广义估计方程来估计住宅驱逐对可检测VL的影响，并检验ART依从性作为中介变量。在2007年6月至2014年5月期间，705名art暴露参与者被纳入研究，其中500人（70.9%）经历了至少一个可检测的VL期。在一个时间更新的多变量模型中，驱逐独立地增加了驱逐后无家可归者（调整优势比[AOR] = 2.25； 95%置信区间[CI]: 1.18 - 4.29）和非无家可归者（AOR = 1.76; 95% CI: 1.17 - 2.63）可检测到VL的几率。中介分析的结果表明，这种关联是由不完全的抗逆转录病毒治疗依从性介导的。这些发现表明，需要进一步发展和评估干预措施，以防止驱逐，并促进面临驱逐的puwud坚持抗逆转录病毒治疗。
We examined the relationship between residential eviction and exhibiting detectable plasma HIV-1 RNA viral load (VL) among a prospective cohort of antiretroviral therapy (ART)-exposed HIV-seropositive people who use illicit drugs (PWUD) in Vancouver, Canada. We used multivariable generalized estimating equations to estimate the effect of residential eviction on detectable VL and examine ART adherence as a mediating variable. Between June 2007 and May 2014, 705 ART-exposed participants were included in the study, among whom 500 (70.9%) experienced at least one period of detectable VL. In a time-updated multivariable model, eviction independently increased the odds of detectable VL among those who were homeless (adjusted odds ratio [AOR] = 2.25; 95% confidence interval [CI]: 1.18 – 4.29) as well as not homeless (AOR = 1.76; 95% CI: 1.17 – 2.63) post eviction. The results of mediation analyses suggest that this association was mediated by incomplete ART adherence. These findings suggest the need for further development and evaluation of interventions to prevent evictions and promote ART adherence among PWUD facing eviction.