Predictors and Risk-Taking Consequences of Drug Use Among HIV-Infected Women

Novotná, Lenka; Wilson, Tracey E.; Minkoff, Howard; McNutt, Louise Anne; DeHovitz, Jack; Ehrlich, Ira F.; Jarlais, Don C. Des

doi:10.1097/00042560-199904150-00014

Cited by 16 publications

(6 citation statements)

References 30 publications

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“…Now, difficulty in establishing care can be added to that list. Previous research has also associated substance use with greater risk of unprotected sexual encounters (Eich-Hochli et al, 1998;Hays et al, 1997;Novotna et al, 1999). Clearly, efforts to identify and treat substance users should begin as soon as clients enter a care system.…”

Section: Discussionmentioning

confidence: 99%

Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure

et al. 2005

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To measure the success with which patients newly entering outpatient care establish regular care, and assess whether race/ethnicity was a predictive factor, we conducted a medical record review of new patients seen 20 April 1998 to 31 December 1998 at The Thomas Street Clinic, a county clinic for uninsured persons. Patients were considered 'not established' if they never saw a physician in the 6 months after intake (the 'initial period'), 'poorly established' if seen but a > 6-month gap in care began in the initial period, and 'established' if there were no such gaps. Of 404 patients, 11% were 'not established', 37% 'poorly established', and 53% 'established'. Injection drug use as HIV risk factor (IDU), admitted current alcohol and drug use, age < 35 years, and CD4 count > or = 200 cells/mm(3) were most common in the 'not established' group and least common in the 'established' group. In multivariate ordinal logistic regression, difficulty establishing care was associated with IDU, admitted current alcohol use, and admitted former drug use. Age > 35 years was protective. Half the indigent patients entering care in this single-site study fail to establish regular care. Substance use and younger age are predictors of failure to establish care.

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Section: Discussionmentioning

confidence: 99%

Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure

et al. 2005

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“…It is likely that those in the WIHS cohort at highest risk for HCV acquisition had already acquired infection before enrollment. Additionally, once enrolled in the study, the WIHS participants were likely to receive standard counseling regarding safe sex practices and risk of ongoing drug use, although the impact of such messages is unclear [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Incident Hepatitis C Virus in Women with Human Immunodeficiency Virus Infection

Augenbraun

Goedert

Thomas

et al. 2003

Clinical Infectious Diseases

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Individuals infected with human immunodeficiency virus type 1 (HIV-1) are frequently coinfected with hepatitis C virus (HCV). Acute HCV infection is often asymptomatic and poorly understood. We conducted a historical prospective study of HCV antibody and viremia in plasma samples obtained during 1994-1999 from a cohort of initially HIV-1-infected, HCV-uninfected women and from HIV-1-HCV-uninfected women. Twenty-two (1.5%) of 1517 experienced seroconversion. Of these, 14 (64%) truly acquired a new infection as assessed by enzyme immunoassay response and new-onset viremia. The incidence rate in HIV-1-infected women was 2.7 cases per 1000 person-years; it was 3.3 cases per 1000 person-years in HIV-1-seronegative women (relative risk, 1.21; P=.75). Acquisition of HCV was associated with any history of drug use (P<.01). Five of 12 viremic, seroconverting individuals cleared viremia. Incident HCV infection among HIV-1-infected and HIV-1-uninfected women was low. It was linked to drug use and commonly resolved.

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“…Factors previously shown to be associated with non-adherence include heterosexual orientation and non-Latino ethnicity (Power et al, 2003), older age (Mellins, Kang, Leu, Havens, & Chesney, 2003), increased viral load (Paterson et al, 2000), lower levels of social support (Power et al, 2003), alcohol and drug use (Chesney et al, 2000;Mellins et al, 2003), and depression (Murphy et al, 2001;Paterson et al, 2000). Factors previously shown to be associated with unprotected sex among HIV-positive individuals include alcohol and recreational drug use (Kalichman, 1999;Lee, Galanter, Dermatis, & McDowell, 2003;Novotna et al, 1999), number of sexual partners (Lightfoot, Song, Rotheram-Borus, & Newman, 2005;Wyatt et al, 2002), self-identified homosexual orientation (Denning & Campsmith, 2005), female gender (in studies comparing heterosexual women and men) (Latkin, Forman-Hoffman, D'Souza, & Knowlton, 2004;Tucker, Burnam, Sherbourne, Kung, Gifford, 2003b), education (less than high school among MSM) (Denning & Campsmith, 2005), less social support (Reilly & Woo, 2004;Sherman & Kirton, 1999), viral load (Vanable, Ostrow, & McKirnan, 2003), health status (Sherman & Kirton, 1999), depressive symptoms and lower anxiety among MSM (Parsons, Halkitis, Wolitski, Gomez, & Seropositive Urban Men's Study Team, 2003). The variables examined in this study were sexual orientation, IDU, recreational drug use, number of male and female partners, number of AIDS-related symptoms, viral load, Anger-Burnout, BDI, STAI, perceived stress, social support, self-efficacy for adherence, and attitudes about ART.…”

Section: Data Analysesmentioning

confidence: 99%

Medication Adherence and Sexual Risk Behavior among HIV-Infected Adults: Implications for Transmission of Resistant Virus

et al. 2007

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As more people are living long-term with HIV there are growing concerns about specific behaviors that can affect both personal and the public health. This study examined the relationship between antiretroviral therapy (ART) adherence and sexual risk behavior and their association with psychosocial and health factors among a diverse sample of 2,849 HIV-infected adults. Only 8.5% of the sample reported both non-adherence and sexual risk. Individuals were 46% more likely to report one of these risk outcomes when the other one was present and the presence of both outcomes was associated with an increased likelihood of having a detectable viral load. A simultaneous polytomous regression analysis revealed complex relationships among a range of psychosocial variables and the two primary behavioral risk outcomes. There is a need for targeted interventions and integration of mental health and substance use services into primary HIV care settings.

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Predictors and Risk-Taking Consequences of Drug Use Among HIV-Infected Women

Cited by 16 publications

References 30 publications

Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure

Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure

Incident Hepatitis C Virus in Women with Human Immunodeficiency Virus Infection

Medication Adherence and Sexual Risk Behavior among HIV-Infected Adults: Implications for Transmission of Resistant Virus

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