title: Continued Substance Use Among People Living With HIV-Hepatitis-C Co-Infection and Receiving Antiretroviral Therapy.
abstract: BACKGROUND
  Co-infection with human immunodeficiency virus (HIV) and Hepatitis-C virus (HCV) poses a significant threat to personal and public health. Substance use among co-infected persons leads to increased morbidity and mortality. The purpose of this study is to examine the continued substance use of people living with HIV-HCV co-infection and receiving antiretroviral therapy (ART).
  
  
  METHODS
  Individuals living with HIV infection in Atlanta, GA and currently receiving ART (N = 678) completed audio-computer-assisted self-interviews for demographic, health, and behavior characteristics; unannounced pill counts to assess ART adherence over one month; finger-stick blood specimens collected for HCV antibody testing and urine specimens for drug use screening; and obtained HIV viral load and CD4 cell counts from their medical provider. We performed cross-sectional analyses for behavioral and biological markers of health, health behaviors, and substance use.
  
  
  RESULTS
  Among participants, 131 (19%) were HIV-HCV co-infected; 53% were HIV-mono-infected, and 60% of HIV-HCV co-infected participants tested positive for use of at least one non-alcohol drug: tetrahydrocannabinol (THC) and cocaine were most prevalent. HIV-HCV co-infected individuals were older, with no other significant differences. Within the HIV-HCV co-infected participants, drug users (N = 87) did not differ from non-drug users (N = 53) in terms of ART adherence. However, drug users were significantly more likely to have uncontrolled HIV (17%) compared with those who did not test drug positive (4%).
  
  
  CONCLUSIONS
  Substance use is prevalent in persons with HIV-HCV co-infection and may interfere with ART. Research with a larger and more representative sample is needed to replicate and confirm these results.
authors.affiliation: a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA.
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.affiliation: a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Washington
authors.affiliation: a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kegler
authors.affiliation: a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA.
authors.forename: Tamar
authors.initials: T
authors.lastname: Grebler
authors.affiliation: a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA.
authors.forename: Moira O
authors.initials: MO
authors.lastname: Kalichman
authors.affiliation: a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA.
authors.forename: Chauncey
authors.initials: C
authors.lastname: Cherry
authors.affiliation: a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Eaton
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003042:Cocaine / Q000652:urine; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology; D003430:Cross-Sectional Studies; D013759:Dronabinol / Q000652:urine; D005260:Female; D005845:Georgia / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D015438:Health Behavior; D006508:Hepatitis Antibodies / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D055118:Medication Adherence; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology; D015995:Prevalence; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000652:urine; D019562:Viral Load
chemical_list: D006508:Hepatitis Antibodies; D013759:Dronabinol; D003042:Cocaine
keywords: HIV/AIDS, Hepatitis-C, HIV-HCV co-infection, comorbidity