The relationship of smoking and unhealthy alcohol use to the HIV care continuum among people with HIV in an integrated health care system.
Alcohol
HIV care continuum
Integrated health care
Primary care
Smoking
Viral control
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
received:
21
07
2020
revised:
12
11
2020
accepted:
03
12
2020
pubmed:
12
1
2021
medline:
12
5
2021
entrez:
11
1
2021
Statut:
ppublish
Résumé
Smoking tobacco and unhealthy alcohol use may negatively influence HIV care continuum outcomes but have not been examined in combination. Participants were people with HIV (PWH) in Kaiser Permanente Northern California. Predictors included smoking status and unhealthy alcohol use (exceeding daily and/or weekly limits) reported by patients during primary care screening (index date). Outcomes were based on not achieving the following steps in the care continuum: linkage to HIV care (≥1 visit within 90 days of newly identified HIV diagnosis), retention (2+ in-person visits, 60+ days apart) and HIV RNA control (<75 copies/mL). Adjusted odds ratios (ORs) were obtained from separate logistic regression models for each outcome associated with smoking and unhealthy alcohol use independently and combined. The overall sample (N = 8958) had a mean age of 48.0 years; was 91.3 % male; 54.0 % white, 17.6 % Latino, 15.1 % black, and 9.6 % other race/ethnicity. Smoking was associated with higher odds of not being linked to HIV care (OR = 1.60 [95 % CI 1.03-2.48]), not retained (OR = 1.30 [95 % CI 1.13-1.50]), and HIV RNA not in control (OR = 1.91 [95 % CI 1.60-2.27]). Alcohol measures were not independently associated with outcomes. The combination of unhealthy alcohol use and smoking (versus neither) was associated with higher odds of not being linked to care (OR = 2.83 [95 % CI 1.40-5.71]), although the interaction did not reach significance (p = 0.18). In this large sample of PWH in an integrated health care system, smoking, both independently and in combination with unhealthy alcohol use, was associated with worse HIV care continuum outcomes.
Identifiants
pubmed: 33429295
pii: S0376-8716(20)30646-3
doi: 10.1016/j.drugalcdep.2020.108481
pmc: PMC7869693
mid: NIHMS1658668
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
108481Subventions
Organisme : NIAAA NIH HHS
ID : U01 AA026230
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : NIDA NIH HHS
ID : T32 DA007250
Pays : United States
Organisme : Medical Research Council
ID : MR/J002380/1
Pays : United Kingdom
Organisme : NCATS NIH HHS
ID : UL1 TR002544
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI027763
Pays : United States
Organisme : NIAAA NIH HHS
ID : K24 AA025703
Pays : United States
Organisme : Medical Research Council
ID : G0100221
Pays : United Kingdom
Organisme : NIAAA NIH HHS
ID : U01 AA026209
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA025902
Pays : United States
Organisme : Medical Research Council
ID : G0700820
Pays : United Kingdom
Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
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