Details

Autor(en) / Beteiligte

• Hartzler, Bryan
• Dombrowski, Julia C.
• Williams, Jason R.
• Crane, Heidi M.
• Eron, Joseph J.
• Geng, Elvin H.
• Mathews, Christopher
• Mayer, Kenneth H.
• Moore, Richard D.
• Mugavero, Michael J.
• Napravnik, Sonia
• Rodriguez, Benigno
• Donovan, Dennis M.

Titel

Influence of Substance Use Disorders on 2-Year HIV Care Retention in the United States

Ist Teil von

• AIDS and behavior, 2018-03, Vol.22 (3), p.742-751

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• Substance use disorders (SUDs) are thought to predict care discontinuity, though magnitude and substance-specific variance of effects are unclear. This report of analytic work undertaken with a multi-regional American cohort of 9153 care enrollees addresses these gaps. Care retention was computed from 24-month post-linkage clinic visit documentation, with SUD cases identified from patient-report screening instruments. Two generalized estimating equations tested binary and hierarchial SUD predictors of retention, and potential effect modification by patient age-group, sex, and care site. Findings demonstrate: (1) detrimental SUD effect, equivalent to a nine percentage-point decrease in retention, with independent effects of age-group and care site; (2) substance-specific effect of marijuana UD associated with lower retention; and (3) age-modification of each effect on care discontinuity, with SUDs serving as a risk factor among 18–29 year-olds and protective factor among 60+ year-olds. Collective findings document patient attributes as influences that place particular subgroups at-risk to discontinue care.