Article

Individual, interpersonal, and structural correlates of effective HAART use among urban active injection drug users

University of California, San Francisco, San Francisco, California, United States
JAIDS Journal of Acquired Immune Deficiency Syndromes (Impact Factor: 4.39). 05/2006; 41(4):486-92. DOI: 10.1097/01.qai.0000186392.26334.e3
Source: PubMed

ABSTRACT Among individuals receiving highly active antiretroviral therapy (HAART), injection drug users (IDUs) are less likely to achieve HIV suppression. The present study examined individual-level, interpersonal, and structural factors associated with achieving undetectable plasma viral load (UVL) among US IDUs receiving recommended HAART. Data were from baseline assessments of the INSPIRE (Interventions for Seropositive Injectors-Research and Evaluation) study, a 4-site, secondary HIV prevention intervention for heterosexually active IDUs. Of 1113 study participants at baseline, 42% (n = 466) were currently taking recommended HAART (34% were female, 69% non-Hispanic black, 26% recently homeless; median age was 43 years), of whom 132 (28%) had a UVL. Logistic regression revealed that among those on recommended HAART, adjusted odds of UVL were at least 3 times higher among those with high social support, stable housing, and CD4 > 200; UVL was approximately 60% higher among those reporting better patient-provider communication. Outpatient drug treatment and non-Hispanic black race and an interaction between current drug use and social support were marginally negatively significant. Among those with high perceived support, noncurrent drug users compared with current drug users had a greater likelihood of UVL; current drug use was not associated with UVL among those with low support. Depressive symptoms (Brief Symptom Inventory) were not significant. Results suggest the major role of social support in facilitating effective HAART use in this population and suggest that active drug use may interfere with HAART use by adversely affecting social support. Interventions promoting social support functioning, patient-provider communication, stable housing, and drug abuse treatment may facilitate effective HAART use in this vulnerable population.

0 Followers
 · 
96 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Homelessness & Health in Canada explores, for the first time, the social, structural, and environmental factors that shape the health of homeless persons in Canada. Covering a wide range of topics from youth homelessness to end-of-life care, the authors strive to outline policy and practice recommendations to respond to the ongoing public health crisis. This book is divided into three distinct but complimentary sections. In the first section, contributors explore how homelessness affects the health of particular homeless populations, focusing on the experiences of homeless youth, immigrants, refugees and people of Aboriginal ancestry. In the second section, contributors investigate how housing and public health policy as well as programmatic responses can address various health challenges, including severe mental illness and HIV/AIDS. In the final section, contributors highlight innovative Canadian interventions that have shown great promise in the field. Together, they form a comprehensive survey of an all too important topic and serve as a blueprint for action.
    Edited by Manal Guirguis-Younger, Stephen W. Hwang, Ryan McNeil, 04/2014; University of Ottawa Press., ISBN: 9780776621487
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction Cigarette smoking is highly prevalent among people living with HIV, and is associated with many negative health outcomes, including death. There is little research on smoking behaviors such as interest in quitting and lifetime quit attempts among smokers living with HIV. Existing research has focused on individual-level characteristics, to the neglect of social environmental characteristics. We explored individual- and social-level characteristics associated with interest in quitting and lifetime nicotine replacement (NRT) or medication use for smoking cessation. Methods Data are from a study of participants recruited from clinic and community venues originally designed to examine social environmental influences on current/former drug users’ HIV medication adherence and health outcomes. This analysis comprised 267 current smokers living with HIV. Chi-square tests were used to describe the sample; logistic regression was used to explore associations between covariates and outcomes. Results In adjusted analyses, older age (age 54-65: aOR = 4.64, 95% CI = 1.59-13.47) and lifetime use of NRT/medications (aOR = 2.02, 95% CI = 1.08-3.80) were associated with an interest in quitting smoking. Additionally, older age (age 45-49: aOR = 3.38, 95% CI = 1.57-7.26; age 54-65: aOR = 2.70 95% CI = 1.20-6.11), White race (aOR = 3.56, 95% CI = 1.20-10.62), and having a Supporter who had used NRT/medications for cessation (aOR = 2.13, 95% CI = 1.05-4.29) were associated with lifetime NRT/medications use. Conclusions Findings corroborate prior research concerning individual-level characteristics, and indicate the importance of social-level characteristics in association with prior use of NRT/medications for cessation. Findings have implications for the implementation of cessation interventions for smokers living with HIV.
    Drug and alcohol dependence 05/2014; DOI:10.1016/j.drugalcdep.2014.02.008 · 3.28 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Homelessness & Health in Canada explores, for the first time, the social, structural, and environmental factors that shape the health of homeless persons in Canada. Covering a wide range of topics from youth homelessness to end-of-life care, the authors strive to outline policy and practice recommendations to respond to the ongoing public health crisis. This book is divided into three distinct but complimentary sections. In the first section, contributors explore how homelessness affects the health of particular homeless populations, focusing on the experiences of homeless youth, immigrants, refugees and people of Aboriginal ancestry. In the second section, contributors investigate how housing and public health policy as well as programmatic responses can address various health challenges, including severe mental illness and HIV/AIDS. In the final section, contributors highlight innovative Canadian interventions that have shown great promise in the field. Together, they form a comprehensive survey of an all too important topic and serve as a blueprint for action.
    04/2014; University of Ottawa Press., ISBN: 978-0-7766-2148-7