Associations between methamphetamine use and lack of viral suppression among a cohort of HIV-positive persons who inject drugs in Hai Phong, Vietnam.
Associations between methamphetamine use and lack of viral suppression among a cohort of HIV-positive persons who inject drugs in Hai Phong, Vietnam.
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DOI：
10.1097/qad.0000000000002680
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发表时间：
2020-11-01
期刊：
影响因子：
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通讯作者：
DRIVE STUDY TEAM
中科院分区：
文献类型：
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作者：
Feelemyer J;Arasteh K;Huong DT;Oanh KTH;Khue PM;Giang HT;Thanh NTT;Moles JP;Vinh VH;Vallo R;Quillet C;Rapoud D;Le SM;Michel L;Laureillard D;Nagot N;Des Jarlais DC;DRIVE STUDY TEAM
我们评估了越南海丰一群注射毒品的艾滋病毒血清阳性者（PWID）中甲基苯丙胺使用与缺乏病毒抑制之间的关系。ART依从性的随机效应logit建模和中介分析队列研究。从2016年10月至2017年10月招募了PWID;将HIV血清阳性PWID纳入队列，以评估24个月随访期间的HIV病毒载量、药物使用变化、风险行为和ART依从性。过去30天内使用甲基苯丙胺的情况分为三类：0天（未使用）、1-19天（中间）和20天或更长时间（大量）。使用双变量和多变量随机效应logit模型评估甲基苯丙胺使用与未被病毒抑制之间的关系。我们还评估了自我报告的ART依从性作为中介因素。基线时共纳入645例HIV血清阳性PWID; 95%为男性，平均年龄40岁（SD=6.4）。在基线时，过去30天内使用甲基苯丙胺的比例为64%未使用，32%中间使用，4%重度使用。大约74%的PWID报告了高/完全依从性; 76%处于病毒抑制状态。在随机效应分析中，近期使用甲基苯丙胺与随访期间未受到病毒抑制相关（AOR：1.84，95%CI：1.06，3.17）;自我报告的ART依从性的中介效应无法解释该效应。近期使用甲基苯丙胺与PWID中未受到病毒抑制相关。这项研究的结果表明，需要有针对性的干预甲基苯丙胺的使用，特别是对艾滋病毒感染者的重点。
We assessed the association between methamphetamine use and lack of viral suppression among a cohort of HIV seropositive persons who inject drugs (PWID) in Hai Phong, Vietnam. Cohort study with random effects logit modeling and mediation analysis for ART adherence. PWID were recruited from October 2016-October 2017; HIV seropositive PWID were enrolled in a cohort to assess HIV viral loads, changes in drug use, risk behaviors, and ART adherence during 24-month follow-up. Methamphetamine use in last 30 days was divided into three categories: 0 days (no use), 1–19 days (intermediate), and 20 or more days (heavy). Bivariate and a multivariable random effects logit models were used to assess the relationship between methamphetamine use and not being virally suppressed. We also assessed self-reported ART adherence as a mediating factor. A total of 645 HIV seropositive PWID were included at baseline; 95% male, average age 40 (SD=6.4). At baseline, methamphetamine use in last 30 days was 64% no use, 32% intermediate use, 4% heavy use. Approximately 74% of PWID reported high/complete adherence; 76% were at viral suppression. In random effects analysis, recent methamphetamine use was associated with not being virally suppressed during follow-up (AOR: 1.84, 95% CI: 1.06, 3.17); the effect was not explained by a mediating effect of self-reported adherence to ART. Recent methamphetamine use is associated with not being virally suppressed among PWID. The results of this study indicate the need for targeted interventions for methamphetamine use with special focus on those with HIV infection.