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Impact of Illicit Drug Use on Health-Related Quality of Life in Opioid-Dependent Patients Undergoing HIV Treatment.

ABSTRACT: OBJECTIVE:To assess the impact of illicit drug use on health-related quality of life (health utility) among opioid-dependent HIV-infected patients. DESIGN:Secondary analyses of data from the Buprenorphine-HIV Evaluation and Support cohort of HIV-infected patients with opioid dependence in 9 US HIV clinics between 2004 and 2009. Health status [short form-12 (SF-12)], combination antiretroviral treatment (ART) status, CD4 cell count, hepatitis C virus antibody status, current drug use, and demographics were assessed at the initial visit and quarterly follow-up visits until 1 year. The SF-6D health utility scores were derived from the SF-12. Multivariate mixed-effects regression models were used to assess the impact of illicit drug use on health utility controlling for demographic, clinical, and social characteristics. RESULTS:Health utility was assessed among 307 participants, 67% male, with a median age of 46 years at 1089 quarterly assessments. In multivariate analyses, illicit opioid use, nonopioid illicit drug use, not being on ART, and being on ART with poor adherence were associated with lower health utility. The observed decrement in health utility associated with illicit opioid use was larger for those on ART with good adherence (beta = -0.067; P < 0.01) or poor adherence (-0.049; P < 0.01) than for those not on ART. CONCLUSIONS:Illicit opioid and nonopioid drug use are negatively associated with health utility in patients with HIV; however, the relative effect of illicit opioid use is smaller than that of not being on ART. Postponing ART until initiation of opioid substitution therapy or abstinence may have limited benefits from the perspective of maximizing health utility.

SUBMITTER: Aden B

PROVIDER: S-EPMC4607646 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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Impact of Illicit Drug Use on Health-Related Quality of Life in Opioid-Dependent Patients Undergoing HIV Treatment.

Aden Brandon B Dunning Allison A Nosyk Bohdan B Wittenberg Eve E Bray Jeremy W JW Schackman Bruce R BR

Journal of acquired immune deficiency syndromes (1999) 20151101 3

<h4>Objective</h4>To assess the impact of illicit drug use on health-related quality of life (health utility) among opioid-dependent HIV-infected patients.<h4>Design</h4>Secondary analyses of data from the Buprenorphine-HIV Evaluation and Support cohort of HIV-infected patients with opioid dependence in 9 US HIV clinics between 2004 and 2009. Health status [short form-12 (SF-12)], combination antiretroviral treatment (ART) status, CD4 cell count, hepatitis C virus antibody status, current drug u ...[more]

PMID: 26218410

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Project description:BACKGROUND:To explore the use of illicit drugs by people living with HIV (PLHIV) taking antiretroviral therapy (ART) and their relationship with variables relevant to the management of HIV infection, such as knowledge and beliefs about drug-drug interactions (DDIs), ART adherence, quality of life (QoL), and use of health-care resources. METHODS:21 PLHIV in Spain who concomitantly took illicit drugs and ART participated in this qualitative study. Eight experts collaborated in the design of the semi-structured interview guide which explored the following topics: illicit drug use, knowledge and beliefs about DDIs and their impact on ART adherence, the effects of using illicit drugs on health, QoL, and use of health-care resources. Four of those experts, who were PLHIV and members of the executive boards of non-government organizations (NGOs) from four Spanish regions, recruited the participants through their NGOs and carried out the face-to-face interviews. Content analysis of the qualitative data was conducted with the support of the MAXQDA 12 program. RESULTS:Participants were mainly men (85.7%) and only 14.3% of them were heterosexual. Content analysis showed that the most frequently consumed illicit drugs were poppers, cocaine, and cannabis. Participants were polydrug users and this was, in many cases, prior to HIV diagnosis. Most participants presented theoretical potential moderate DDIs that would require monitoring. More than three quarters of them were not aware of these DDIs. Participants reported interactive toxicity beliefs that lead to intentional nonadherence behaviors. In most cases (n?=?17), the participant's doctor knew about their drug use, however only six of them had had an open dialogue with their physician about it. Illicit drug use led to some health-related problems, mainly sexually transmitted infections. A positive QoL's self-perception was found among several participants that used recreational illicit drugs. CONCLUSIONS:Adequate information about DDIs and clues about how to manage ART when PLHIV are using illicit drugs could reduce the negative effects of such interactions and improve ART adherence and QoL.

Dataset Information

Impact of Illicit Drug Use on Health-Related Quality of Life in Opioid-Dependent Patients Undergoing HIV Treatment.

Publications

Impact of Illicit Drug Use on Health-Related Quality of Life in Opioid-Dependent Patients Undergoing HIV Treatment.

Similar Datasets

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