Correlates of Antiretroviral Utilization Among Hospitalized HIV-Infected Crack Cocaine Users
Year: 2012
Type: article
Study design: Observational Study
Abstract: Despite the availability of antiretroviral therapy (ART), HIV-infected drug users, particularly crack cocaine users, continue to have high HIV-related morbidity and mortality. We conducted a cross-sectional analysis of the baseline data for hospitalized HIV-infected crack cocaine users recruited for Project HOPE (Hospital Visit Is an Opportunity for Prevention and Engagement with HIV-Positive Crack Users) in Atlanta and Miami who were eligible for ART (reported any lifetime use of ART or CD4 <350 cells/μl). Among 350 eligible participants, whose mean age was 44.9 years (SD 7.0), 49% were male, 90% were black, and 81% were heterosexual. The median CD4 count was 144 cells/μl, and 78 of 350 (22%) were taking ART. We conducted a multivariable logistic regression to examine individual, interpersonal, and structural factors as potential correlates of ART use. Reporting ≥2 visits to outpatient HIV care in the past 6 months (AOR 7.55, 95% CI 3.80-14.99), drug or alcohol treatment in the past 6 months (AOR 2.29, 95% CI 1.06-4.94), and study site being Miami (AOR 2.99, 95% CI 1.56-5.73) were associated with ART use. Current homelessness (AOR 0.41, 95% CI 0.20-0.84) and CD4 <200 cells/μl (AOR 0.29, 95% CI 0.15-0.55) were negatively associated with ART use. Among those taking ART, 60% had an HIV-1 viral load <400 copies/ml; this represented 9% of the eligible population. For HIV-infected crack cocaine users, structural factors may be as important as individual and interpersonal factors in facilitating ART utilization. Few HIV(+) crack cocaine users had viral suppression, but among those on ART, viral suppression was achievable.
Authors: Rupali Kotwal Doshi, Nicholas S. Vogenthaler, Sarah Lewis, Allan Rodriguez, Lisa Metsch, Carlos del Rio
Institutions: Emory University, Barry University, University of Miami
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Atlanta Clinical and Translational Science Institute (UL1), G3138949240, Prevention among HIV+ Crack Users in the Hospital, G3938678028, G425202921, Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, G6514887855, G9000089011, G9000228150, Center for AIDS Research at Emory University, Miami Center for AIDS Research
OpenAlex ID: W2023522872