Substance use in older HIV-infected patients.
OBJECTIVE
Substance use may persist throughout the life course and has a substantial impact on health outcomes globally. As HIV-infected individuals are disproportionately impacted by substance use and living longer, it is critical that providers and researchers alike understand the impact of substance use on older, HIV-infected patients and potential treatment options. To this end, we conducted a review of the literature focusing on the most commonly used substances to outline the epidemiology, health consequences, treatment options and latest research relevant to older, HIV-infected patients.


RESULTS
Substance use impacts older, HIV-infected patients with regards to HIV-related and non-HIV-related outcomes. Counseling strategies are available for marijuana and stimulant use disorders. Brief counseling is useful alongside medications for alcohol, tobacco and opioid use disorders. Many medications for alcohol, tobacco and opioid use disorders are safe in the setting of antiretroviral therapy. Unfortunately, few interventions targeting substance use in older, HIV-infected patients have been developed and evaluated.


CONCLUSIONS
As older, HIV-infected patients continue to experience substance use and its related health consequences, there will be a growing need for the development of safe and effective interventions, which address the complex needs of this population.
aYale University School of Medicine bCenter for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, Connecticut, USA.
E Jennifer
EJ
Edelman
Jeanette M
JM
Tetrault
David A
DA
Fiellin
D000375:Aging; D000437:Alcoholism; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D012907:Smoking; D019966:Substance-Related Disorders / Q000453:epidemiology*