Prevalence and patterns of illicit drug use in people living with HIV in Spain: A cross-sectional study

Abstract

This study assessed the prevalence and patterns of drug use among people living with HIV (PLHIV) in Spain. We conducted an observational cross-sectional study including 1401 PLHIV. Data were collected through 33 sites across Spain using an online computer-assisted self-administered interview. The survey measured use of illicit drugs and other substances, treatment adherence and health-related variables. To analyse patterns of drug use we performed cluster analysis in two stages. The most frequently consumed substances were: alcohol (86.7%), tobacco (55.0%), illicit drugs (49.5%), other substances (27.1%). The most prevalent illicit drugs used were cannabis (73.8%), cocaine powder (53.9%), and poppers (45.4%). Results found four clusters of PLHIV who used drugs. Two of them were composed mainly of heterosexuals (HTX): Cluster 1 (n = 172) presented the lowest polydrug use and they were mainly users of cannabis, and Cluster 2 (n = 84) grouped mostly men who used mainly heroin and cocaine; which had the highest percentage of people who inject drugs and presented the lowest level of treatment adherence (79.8±14.2; p < .0001). The other two clusters were composed mainly of men who have sex with men (MSM), who were mostly users of recreational drugs. Cluster 3 (n = 285) reported moderate consumption, both regarding frequency and diversity of drugs used, while Cluster 4 (n = 153) was characterized by the highest drug polyconsumption (7.4±2.2; p < .0001), and 4 grouped MSM who injected recreational drugs, and who reported the highest frequency of use of drugs in a sexual context (2.6±0.8; p < .0001) and rates of sexually transmitted infections (1.8±1.1; p < .01). This is the largest multi-centre cross-sectional study assessing the current prevalence and patterns of drug use among PLHIV in Spain. The highest prevalence of drug use was found among MSM, although HTX who used heroin and cocaine (Cluster 2) had the most problems with adherence to HIV treatment and the worst health status.

Prevalence and patterns of illicit drug use in people with human immunodeficiency virus infection in Korea

“…In this retrospective cross-sectional study, we found that approximately 5% of HIV-infected patients had used one or more illicit drugs in their lifetime, and approximately half of them used an injection drug. Although the reported prevalence of illicit drug use by patients infected with HIV can substantially vary among studies due to the differences in the definition of illicit drugs, subject characteristics, and investigated period, the prevalence observed in the present study is substantially lower than that in many other countries, where it ranges from 12% to 86% [ 1 , 13 – 18 ]. Nevertheless, this is significantly higher than the prevalence of 0.045%–0.07% in all selected subjects reported by previous studies in Korea [ 6 , 7 ].…”

Multimorbidity patterns in people with HIV

“…In some way, these are all interrelated with lifestyle and behavioural factors, including the sexually transmitted disease pattern which is likely to reflect exposure to the same common sexual behaviours. These lifestyle-related patterns are expected to be particularly frequent in PWH (compared to the general population) given the higher prevalence of substance use and risk-taking sexual behaviours often reported among populations of PWH (42)(43)(44)(45).…”

Recreational Drug Use in People Living with HIV in Spain: Factors Associated with Drug Use and the Impact on Clinical Outcomes

“…Advances in knowledge of HIV infection, as well as the emergence of new therapies, have revolutionised the natural history of the infection, which is currently considered a chronic disease with mortality rates similar to those of the general population [1]. This paradigm shift requires the adaptation of approaches to other emerging problems that can have a decisive impact on the management of HIV, including the prevalence of recreational drug use (RDU) which has potential implications for people living with HIV (PLHIV) in Spain [2,3].…”

“…The prevalence of this profile has decreased from 1994 to 2010, reducing from 3.26 to 0.49 PWID per 1000 inhabitants, thanks to the implementation of specific harm reduction policies [6]. In return, the prevalence of drug use in the ludic or recreational environment has increased by about 50% amongst PLHIV, as studies conducted in Spain and elsewhere in Europe have shown [3,[7][8][9][10][11]. These have placed special emphasis on "polyconsumption," which is especially predominant in men who have sex with men (MSM) with HIV [12,13].…”