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. 2022 Nov 4;7(11):349.
doi: 10.3390/tropicalmed7110349.

Substance Use and Adherence to Antiretroviral Therapy among People Living with HIV in the United States

Sarahmona Przybyla  1 , Rebecca L Ashare  2 , Loriann Cioffi  3 , Isabella Plotnik  3 , Jonathan Shuter  4   5   6 , Elizabeth K Seng  3   4   5   6 , Andrea H Weinberger  3   4   5   6
Affiliations

Substance Use and Adherence to Antiretroviral Therapy among People Living with HIV in the United States

Sarahmona Przybyla et al. Trop Med Infect Dis. .

Abstract

People with HIV (PWH) report substance use at higher rates than HIV-uninfected individuals. The potential negative impact of single and polysubstance use on HIV treatment among diverse samples of PWH is underexplored. PWH were recruited from the Center for Positive Living at the Montefiore Medical Center (Bronx, NY, USA) from May 2017-April 2018 and completed a cross-sectional survey with measures of substance use, antiretroviral therapy (ART) use, and ART adherence. The overall sample included 237 PWH (54.1% Black, 42.2% female, median age 53 years). Approximately half of the sample reported any current substance use with 23.1% reporting single substance use and 21.4% reporting polysubstance use. Polysubstance use was more prevalent among those with current cigarette smoking relative to those with no current smoking and among females relative to males. Alcohol and cannabis were the most commonly reported polysubstance combination; however, a sizeable proportion of PWH reported other two, three, and four-substance groupings. Single and polysubstance use were associated with lower ART adherence. A thorough understanding of substance use patterns and related adherence challenges may aid with targeted public health interventions to improve HIV care cascade goals, including the integration of substance use prevention into HIV treatment and care settings.

Keywords: HIV/AIDS; United States; adherence; antiretroviral therapy; substance use.

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Conflict of interest statement

R.L.A. has an investigator-initiated grant from Novo Nordisk, Inc for a project related to the current study. J.S. has received financial compensation for the development of educational materials and delivering oral presentations from the Northeast/Caribbean AIDS Education and Training Center and from the ObG Project. E.K.S. has consulted or served on an advisory board for GlaxoSmithKline, Click Therapeutics, and Abbvie and received research funding from the NINDS (NS096107 PI: Seng), NCCIH (R01AT011005-01A1 MPIs: Seng and Shallcross), and the Veteran’s Health Administration (the Headache Center of Excellence Research and Evaluation Center and VA HSR&D, IRP 20-002 PI: Damush).

Figures

Figure 1
Figure 1
Comparison of Substance Use by Smoking Status.
Figure 2
Figure 2
Comparison of Substance Use by Gender.
Figure 3
Figure 3
Substance Use Patterns Among a Sample of People with HIV who were ART Adherent (n = 55).
Figure 4
Figure 4
Substance Use Patterns Among a Sample of People with HIV who were ART Non-Adherent (n = 47). 1 participant endorsed use of methamphetamine, cannabis, and alcohol.
See this image and copyright information in PMC

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