Dataset Information

Antiretroviral Therapy Use Among HIV-Infected People Who Inject Drugs-20 Cities, United States, 2009-2015.

ABSTRACT:

Background

Approximately 16% of infections among those living with diagnosed HIV infection in the United States are attributable to injection drug use. Antiretrovirals (ARVs) are recommended for all infected persons to improve health and prevent transmission. Using data from National HIV Behavioral Surveillance, we evaluated changes in ARV use from 2009 to 2015 among HIV-positive people who inject drugs (PWID).

Methods

PWID were recruited by respondent-driven sampling in 20 cities. ARV use was defined as self-reported use at the time of interview. Prevalence ratios measuring change in ARV use per 3-year increase in year were estimated using log-linked Poisson regression models with generalized estimating equations.

Results

ARV use was 58% (319/548) in 2009, 67% (410/608) in 2012, and 71% (386/545) in 2015. In all 3 cycle years, a higher percentage of ARV treatment was observed among males, PWID of older age (?50), and PWID with current health insurance. ARV use increased overall, with an adjusted relative increase of 8% per every 3-year increase in year (adjusted prevalence ratio 1.08, 95% confidence interval: 1.03 to 1.12). ARV use also increased among most subgroups.

Conclusions

These findings show progress in ARV treatment, although ARV coverage remains low compared with other populations at risk for HIV. Efforts to improve ARV coverage among PWIDs are needed.

SUBMITTER: Hoots BE

PROVIDER: S-EPMC7836744 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Publications

Antiretroviral Therapy Use Among HIV-Infected People Who Inject Drugs-20 Cities, United States, 2009-2015.

Hoots Brooke E BE Finlayson Teresa J TJ Broz Dita D Paz-Bailey Gabriela G

Journal of acquired immune deficiency syndromes (1999) 20170701

<h4>Background</h4>Approximately 16% of infections among those living with diagnosed HIV infection in the United States are attributable to injection drug use. Antiretrovirals (ARVs) are recommended for all infected persons to improve health and prevent transmission. Using data from National HIV Behavioral Surveillance, we evaluated changes in ARV use from 2009 to 2015 among HIV-positive people who inject drugs (PWID).<h4>Methods</h4>PWID were recruited by respondent-driven sampling in 20 cities ...[more]

PMID: 28604444

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Project description:ImportanceAt least 500 000 people in the US experience homelessness nightly. More than 30% of people experiencing homelessness also have a substance use disorder. Involuntary displacement is a common practice in responding to unsheltered people experiencing homelessness. Understanding the health implications of displacement (eg, "sweeps," "clearings," "cleanups") is important, especially as they relate to key substance use disorder outcomes.ObjectiveTo estimate the long-term health effects of involuntary displacement of people experiencing homelessness who inject drugs in 23 US cities.Design, setting, and participantsA closed cohort microsimulation model that simulates the natural history of injection drug use and health outcomes among people experiencing homelessness who inject drugs in 23 US cities. The model was populated with city-level data from the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance system and published data to make representative cohorts of people experiencing homelessness who inject drugs in those cities.Main outcomes and measuresProjected outcomes included overdose mortality, serious injection-related infections and mortality related to serious injection-related infections, hospitalizations, initiations of medications for opioid use disorder, and life-years lived over a 10-year period for 2 scenarios: "no displacement" and "continual involuntary displacement." The population-attributable fraction of continual displacement to mortality was estimated among this population.ResultsModels estimated between 974 and 2175 additional overdose deaths per 10 000 people experiencing homelessness at 10 years in scenarios in which people experiencing homelessness who inject drugs were continually involuntarily displaced compared with no displacement. Between 611 and 1360 additional people experiencing homelessness who inject drugs per 10 000 people were estimated to be hospitalized with continual involuntary displacement, and there will be an estimated 3140 to 8812 fewer initiations of medications for opioid use disorder per 10 000 people. Continual involuntary displacement may contribute to between 15.6% and 24.4% of additional deaths among unsheltered people experiencing homelessness who inject drugs over a 10-year period.Conclusion and relevanceInvoluntary displacement of people experiencing homelessness may substantially increase drug-related morbidity and mortality. These findings have implications for the practice of involuntary displacement, as well as policies such as access to housing and supportive services, that could mitigate these harms.

Dataset Information

Antiretroviral Therapy Use Among HIV-Infected People Who Inject Drugs-20 Cities, United States, 2009-2015.

Background

Methods

Results

Conclusions

Publications

Antiretroviral Therapy Use Among HIV-Infected People Who Inject Drugs-20 Cities, United States, 2009-2015.

Similar Datasets

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