Methamphetamine use drives decreases in viral suppression for people living with HIV released from a large municipal jail: Results of the LINK LA clinical trial
Methamphetamine use drives decreases in viral suppression for people living with HIV released from a large municipal jail: Results of the LINK LA clinical trial
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DOI：
10.1016/j.drugalcdep.2019.05.007
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发表时间：
2019-09-01
影响因子：
4.2
通讯作者：
Cunningham, William E.
中科院分区：
文献类型：
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作者：
Goodman-Meza, David;Shoptaw, Steve;Cunningham, William E.
背景-艾滋病病毒感染者（PLWH）从监狱释放后经常经历艾滋病病毒抑制（VS）下降。与标准护理相比，将囚犯与洛杉矶护理联系起来（LINK LA）同伴导航干预有助于在出狱后12个月维持VS。在这项研究中，我们分析了物质使用的相关性，并测试物质使用是否是一个独立的相关性降低VS在LINK LA participator.Methods：我们分析了LINK LA数据收集在基线，3，12个月。我们将高风险药物使用定义为研究访视（或基线入狱）前30天内报告的任何甲基苯丙胺，可卡因或阿片类药物使用。我们使用广义线性混合模型来测试社会人口变量与使用的物质类型之间的关联，并测试VS的相关性，同时控制时间、干预措施及其相互作用。结果：在基线（n = 356），71%的参与者报告了高危药物使用：用途：58%，甲基苯丙胺; 17%，可卡因; 7%，海洛因; 4%，处方阿片类药物。非西班牙裔白人和35岁以下的人最有可能使用甲基苯丙胺;黑人最有可能使用可卡因;注射毒品的人最有可能使用阿片类药物。使用高危药物的受试者维持VS的校正比值比不使用者低53%（AOR 0.47，95%CI 0.31-0.70，p < 0.001）。结论：以甲基苯丙胺为主的高危药物使用与近期监禁的PLWH VS降低独立相关。要改善出狱人口的艾滋病毒护理连续性成果，就需要注意解决高风险药物使用问题。
Background-People living with HIV (PLWH) often experience decreases in HIV viral suppression (VS) after release from jail. The Linking Inmates to Care in LA (LINK LA) peer navigation intervention helped maintain VS 12 months after release from jail compared to standard of care. In this study, we analyzed correlates of substance use and tested whether substance use was an independent correlate of decreased VS in LINK LA participants.Methods: We analyzed LINK LA data collected at baseline, 3, and 12 months. We defined high-risk drug use as any reported methamphetamine, cocaine, or opioid use in the 30 days prior to a study visit (or jail entry at baseline). We used generalized linear mixed models to test associations of sociodemographic variables with type of substance used, and we tested correlates of VS while controlling for time, the intervention, and their interaction.Results: At baseline (n = 356), 71% of participants reported high-risk drug use: 58%, methamphetamine; 17%, cocaine; 7%, heroin; and 4%, prescription opioids. Non-Hispanic Whites and those younger than 35 were most likely to use methamphetamine; Blacks were most likely to use cocaine; people who inject drugs were most likely to use opioids. Participants who used high-risk drugs had 53% lower adjusted odds than non-users of maintaining VS (AOR 0.47, 95% CI 0.31-0.70, p < 0.001).Conclusion: High-risk drug use, dominated by methamphetamine use, independently correlated with decreased VS among recently incarcerated PLWH. Improving HIV care continuum outcomes among populations leaving jail requires attention to efforts to address high-risk drug use.