Short-term binge drinking, marijuana, and recreational drug use trajectories in a prospective cohort of people living with HIV at the start of COVID-19 mitigation efforts in the United States

• Type of Material: Article
• Authors: Steven Meanley, University of Pennsylvania; Seul Ki Choi, University of Pennsylvania; Azure B Thompson, SUNY Downstate Health Sciences University; Jacquelyn L Meyers, SUNY Downstate Health Sciences University; Gypsyamber D'Souza, Johns Hopkins Bloomberg Sch Publ Hlth; Adaora A Adimora, University of North Carolina; Matthew J Mimiaga, University of California Los Angeles; Mirjam-Colette Kempf, University of Alabama Birmingham; Deborah Konkle-Parker, University of Mississippi; Mardge H Cohen, Rush University; Linda A Teplin, Northwestern University; Lynn Murchison, Albert Einstein College of Medicine; Leah H Rubin, Johns Hopkins University; Anna A Rubtsova, Emory University; Deborah Jones Weiss, University of Miami; Brad Aouizerat, New York University; Mackey R Friedman, University of Pittsburgh; Michael W Plankey, Georgetown University; Tracey E Wilson, SUNY Downstate Health Sciences University
• Language: English
• Date: 2022-02-01
• Publisher: ELSEVIER IRELAND LTD
• Publication Version: Final Published Version
• Copyright Statement: © 2021 Published by Elsevier B.V.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.drugalcdep.2021.109233
• Title of Journal or Parent Work: DRUG AND ALCOHOL DEPENDENCE
• Volume: 231
• Start Page: 109233
• End Page: 109233
• Keywords: Psychiatry; COVID-19; Science & Technology; Longitudinal; Life Sciences & Biomedicine; AGES 50; MEN; SUBSTANCE USE; IMPACT; GENDER; ALCOHOL-USE; HEALTH; HIV; WOMEN; INFECTED PATIENTS; Substance Abuse; Substance use
• Research Categories: Health Sciences, Nursing; Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Background: At the start of the COVID-19 pandemic, HIV experts suggested that an increase in mental health diagnoses and substance use among people living with HIV (PLHIV) may be an unintended consequence of COVID-19 mitigation efforts (e.g., limiting social contact). We evaluated short-term trajectories in binge drinking, marijuana, and recreational drug use in a prospective cohort of PLHIV. Methods: Data (N = 2121 PLHIV) consist of survey responses on substance use behaviors from two pre-COVID-19 (October 2018-September 2019) and one COVID-19-era (April 2020-September 2020) timepoints within the MACS/WIHS Combined Cohort Study (MWCCS). We conducted group-based trajectory models, triangulated with generalized linear mixed models, to assess changes in binge drinking, daily marijuana use, and recreational drug use at the start of the pandemic. Controlling for age and race/ethnicity, we tested whether trajectories differed by sex and early-pandemic depressive symptoms, loneliness, and social support. Results: Group-based trajectory models yielded two trajectory groups for binge drinking (none vs. any), marijuana (none/infrequent vs. daily), and recreational drug use (none vs. any). Binge drinking and recreational drug use decreased at the beginning of the pandemic. Generalized linear mixed model supported these trends. Consistent with prior research, male sex and having depressive symptoms early pandemic were positively associated with each substance use outcomes. Social support was inversely associated with recreational drug use. Conclusions: Contrary to hypotheses, problematic substance use behaviors decreased from pre-pandemic to the post-pandemic follow-up in our sample of PLHIV. Ongoing surveillance is needed to assess whether this pattern persists as the pandemic continues.