title: Correlates of drug use cessation among participants in the Canadian HIV-HCV Co-infection Cohort.
abstract: BACKGROUND
  Ongoing drug use remains a barrier to HIV and HCV treatment. We examined the occurrence and correlates of drug use cessation among HIV-HCV co-infected drug users participating in HIV care.
  
  
  METHODS
  Participants from the Canadian Co-infection Cohort reporting drug use (injecting drugs and/or smoking crack) with at least two follow-up visits were included (n=521 (43%), 1832 visits). Socio-demographics, behavioural, and health information were collected at each six-month visit. Associations with cessation (no drug use since last visit) were examined using non-linear mixed effects logistic regression models with random intercepts.
  
  
  RESULTS
  During follow-up, 361 (69%) participants ceased using drugs. Having a fixed address (aOR [adjusted odds ratio] 1.73, CI [95% confidence interval] 1.02-2.96) and smoking crack without injecting drugs (aOR 3.10, CI 2.05-4.71) were positively associated. Living alone (aOR 0.47, CI 0.35-0.63), current tobacco use (aOR 0.41, CI 0.26-0.64), hazardous alcohol drinking (aOR 0.67, CI 0.49-0.91), snorting drugs (aOR 0.52, CI 0.37-0.74), having a greater exposure to addiction programmes (aOR 0.88, CI 0.81-0.94), having been recruited in Quebec or Nova Scotia (aOR 0.41, CI 0.25-0.66), and British Columbia or Alberta (aOR 0.51, CI 0.32-0.82) were negatively associated. Various socio-demographic (age, education) and health-related (HIV duration, care adherence) factors were not associated.
  
  
  CONCLUSIONS
  Drug use cessation among HIV-HCV co-infected persons is relatively common in this cohort. Stable housing and supportive living situations seem to be important facilitators for drug use cessation in this population. Greater efforts should be made to retain patients in addiction treatment programmes.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2; Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4; Public Health Department, Montreal Health and Social Services Agency, 1301 Sherbrooke Street East, Montreal, Quebec, Canada H2L 1M3; CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6. Electronic address: joseph.cox@mcgill.ca.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cox
authors.affiliation: Public Health Department, Montreal Health and Social Services Agency, 1301 Sherbrooke Street East, Montreal, Quebec, Canada H2L 1M3.
authors.forename: Emilie
authors.initials: E
authors.lastname: Maurais
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2.
authors.forename: Lina
authors.initials: L
authors.lastname: Hu
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2.
authors.forename: Erica E M
authors.initials: EE
authors.lastname: Moodie
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Law
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4.
authors.forename: Nikki
authors.initials: N
authors.lastname: Bozinoff
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2; Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4.
authors.forename: Martin
authors.initials: M
authors.lastname: Potter
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Rollet
authors.affiliation: CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6; BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, British Columbia, Canada V6Z 1Y6.
authors.forename: Mark
authors.initials: M
authors.lastname: Hull
authors.affiliation: CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6; Department of Medicine, Infectious Diseases Division, University of Ottawa, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6.
authors.forename: Mark
authors.initials: M
authors.lastname: Tyndall
authors.affiliation: CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6; Department of Medicine, Infectious Diseases Division, University of Ottawa, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6.
authors.forename: Curtis
authors.initials: C
authors.lastname: Cooper
authors.affiliation: CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6; Southern Alberta HIV Clinic, 1213 4 Street SW, Calgary, Alberta, Canada T2R 0X7.
authors.forename: John
authors.initials: J
authors.lastname: Gill
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4.
authors.forename: Sahar
authors.initials: S
authors.lastname: Saeed
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4; CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6.
authors.forename: Marina B
authors.initials: MB
authors.lastname: Klein
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000628:therapy; D006526:Hepatitis C / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D012307:Risk Factors; D016320:Substance Abuse Treatment Centers / Q000639:trends*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000628:therapy
keywords: Crack cessation; Determinants of health; HIV–HCV co-infection; Injection drug use cessation