Substance Use Predicts Sustained Viral Suppression in a Community Cohort of Sexual and Gender Minority Youth Living with HIV

Hall, Casey D. Xavier; Morgan, Ethan; Bundy, Camille; Foran, James E.; Janulis, Patrick; Newcomb, Michael E.; Mustanski, Brian

doi:10.1007/s10461-021-03179-y

Cited by 8 publications

(7 citation statements)

References 88 publications

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“…Therefore, it is understood that viral suppression disruption results in higher morbidity and mortality among PLHIV. 29 In this study, the viral load testing rate according to the guideline-recommended schedule among PLWH was 56.6%, which is lower than the rate of 69% reported in a South African study. 30 The effects of substances on viral suppression have been known to be mediated by adherence.…”

Section: Discussioncontrasting

confidence: 71%

The effect of substance uses on antiretroviral treatment adherence in primary health care

Kaswa

Villiers

2023

South African Family Practice

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Background: Adherence to antiretroviral treatment (ART) is the primary factor determining how an individual responds to their treatment. Unfortunately, individuals who use substances experience suboptimal adherence to their treatment, but little is known about the exact effects of their use on ART adherence in primary health care settings.Methods: The authors used a prospective cohort study to evaluate substance use’s effects on ART adherence among people living with HIV (PLWH) who attend primary health care services in the Mthatha region of South Africa.Results: During the study period, 601 PLWH were followed up for 6 months. The participant’s mean age was 38.5 (standard deviation [s.d.] = 11) years, with a mean CD4 count of 491.7 (s.d. = 241). Suboptimal ART adherence and default rates were 20.2% and 9.3%, respectively. Among the substance users, suboptimal adherence to ART was statistically significantly higher than non-users (24.6% and 15.9%, respectively, p = 0.007). The authors also observed suboptimum ART adherence among people who presented with clinical comorbidities.Conclusion: Substance use has negatively affected ART adherence among PLWH who attend primary health care services in the Eastern Cape province of South Africa. Therefore, an integrated substance use management strategy in primary health care is recommended to achieve optimal adherence to ART.Contribution: Substance use disorder significantly affected the adherence to ART in primary health care. This is important since primary care is the gateway to the HIV care continuum. The study highlighted the role of integration of substance use management in primary care.

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Section: Discussioncontrasting

confidence: 71%

The effect of substance uses on antiretroviral treatment adherence in primary health care

Kaswa

Villiers

2023

South African Family Practice

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“…The study methodology has been published, and weCare has recently been added to the Centers for Disease Control and Prevention’s Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. 8–41 Human protection oversight and approval were provided by the Wake Forest School of Medicine institutional review board.…”

Section: Methodsmentioning

confidence: 99%

“…Racial/ethnic, sexual, and gender minority people living with human immunodeficiency virus (HIV) (PLWH) experience high rates of substance use, including the use of alcohol, tobacco, and marijuana 1–8 . Substance use among PLWH is associated with health-compromising behaviors and negative HIV-related health outcomes, including lower engagement in HIV care, lower adherence to antiretroviral therapy, higher rates of immunosuppression, increased participation in sexual risk behaviors, higher rates of morbidity and mortality, and increased burdens on healthcare systems 9–12 …”

mentioning

confidence: 99%

Stigma, Social Support, and Substance Use in Diverse Men Who Have Sex With Men and Transgender Women Living with HIV in the US Southeast

Schafer¹,

Tanner²,

Mann‐Jackson³

et al. 2022

Southern Medical Journal

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Objectives: Human immunodeficiency virus (HIV) rates in the southeast United States are high and substance use is common among people living with HIV (PLWH). This study used baseline data from the weCare intervention study to examine factors associated with the use of alcohol, tobacco, and marijuana among racially and ethnically diverse young gay, bisexual, and other men who have sex with men (GBMSM) and transgender women in the southeast who were newly diagnosed as having HIV, not linked to care, out of care, and/or not virally suppressed.Methods: Self-reported data were collected from 196 GBMSM and transgender women living with HIV via Audio Computer-Assisted Self-Interview at enrollment. Measures assessed demographics; stigma; social support; basic and clinical service needs; HIV disclosure; social media use; and recent use of alcohol, tobacco, and marijuana. Logistic regression identified correlates of past 30-day substance use. Results:In multivariable analysis, increased age and needing basic support services were associated with past 30-day tobacco, cigarette, electronic cigarette, and/or hookah use. Increased HIV-related stigma and needing basic support services were associated with past 30-day mari-juana use. Being White and needing clinical support services were associated with infrequent or no past 30-day marijuana use.Conclusions: HIV-related stigma and needing basic support services were associated with substance use among GBMSM and transgender women living with HIV in the southeastern United States. Routine screening for basic needs could identify GBMSM and transgender women living with HIV at risk for substance use and offer insight into intervention leverage points.

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“…Another study found that PLWH who exhibit dependence on marijuana use exhibit reduced ART adherence, but those who exhibit non-dependent marijuana use do not ( Bonn-Miller et al, 2014 ). A third study found that problematic cannabis use predicted consistently detectable HIV viral load ( Xavier Hall et al, 2021 ). A meta-analysis found that among PLWH with opioid use disorder, those who were receiving medications to treat opioid use disorder exhibited higher ART adherence and were more likely to exhibit HIV viral suppression ( McNamara et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Accelerated aging in people living with HIV: The neuroimmune feedback model

Schrock

2024

Brain, Behavior, & Immunity - Health

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Substance Use Predicts Sustained Viral Suppression in a Community Cohort of Sexual and Gender Minority Youth Living with HIV

Cited by 8 publications

References 88 publications

The effect of substance uses on antiretroviral treatment adherence in primary health care

The effect of substance uses on antiretroviral treatment adherence in primary health care

Stigma, Social Support, and Substance Use in Diverse Men Who Have Sex With Men and Transgender Women Living with HIV in the US Southeast

Accelerated aging in people living with HIV: The neuroimmune feedback model

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