title: Prevalence and Predictors of Substance Use Disorders Among HIV Care Enrollees in the United States.
abstract: Prior efforts to estimate U.S. prevalence of substance use disorders (SUDs) in HIV care have been undermined by caveats common to single-site trials. The current work reports on a cohort of 10,652 HIV-positive adults linked to care at seven sites, with available patient data including geography, demography, and risk factor indices, and with substance-specific SUDs identified via self-report instruments with validated diagnostic thresholds. Generalized estimating equations also tested patient indices as SUD predictors. Findings were: (1) a 48 % SUD prevalence rate (between-site range of 21-71 %), with 20 % of the sample evidencing polysubstance use disorder; (2) substance-specific SUD rates of 31 % for marijuana, 19 % alcohol, 13 % methamphetamine, 11 % cocaine, and 4 % opiate; and (3) emergence of younger age and male gender as robust SUD predictors. Findings suggest high rates at which SUDs occur among patients at these urban HIV care sites, detail substance-specific SUD rates, and identify at-risk patient subgroups.
authors.affiliation: Alcohol & Drug Abuse Institute, University of Washington, Box 354805, 1107 NE 45th Street, Suite 120, Seattle, WA, 98105-4631, USA. hartzb@u.washington.edu.
authors.forename: Bryan
authors.initials: B
authors.lastname: Hartzler
authors.affiliation: Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA.
authors.forename: Julia C
authors.initials: JC
authors.lastname: Dombrowski
authors.affiliation: Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA.
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Crane
authors.affiliation: Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.|Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Eron
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Elvin H
authors.initials: EH
authors.lastname: Geng
authors.affiliation: Department of Medicine, University of California, San Diego, CA, USA.
authors.forename: W
authors.initials: W
authors.lastname: Christopher Mathews
authors.affiliation: School of Medicine, Harvard University, Boston, MA, USA.|School of Public Health, Harvard University, Boston, MA, USA.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.|Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.|Center for Global Health, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.affiliation: Department of Medicine, University of Alabama, Birmingham, AL, UK.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
authors.affiliation: Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Napravnik
authors.affiliation: Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Benigno
authors.initials: B
authors.lastname: Rodriguez
authors.affiliation: Alcohol & Drug Abuse Institute, University of Washington, Box 354805, 1107 NE 45th Street, Suite 120, Seattle, WA, 98105-4631, USA.|Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Donovan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology; D019969:Amphetamine-Related Disorders / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D008694:Methamphetamine; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D008694:Methamphetamine
keywords: HIV care settings; Patient demography; Substance use disorders; United States