Substance Use Treatment Utilization Among Women With and Without Human Immunodeficiency Virus

• Type of Material: Article
• Authors: Ayako W. Fujita, Emory University; Aditi Ramakrishnan, Emory University; Christina Mehta, Emory University; Oyindamola B. Yusuf, Emory University; Tracey Wilson, State University of New York; Steven Shoptaw, University of California Los Angeles; Adam W. Carrico, University of Miami; Adaora A. Adimora, University of North Carolina; Ellen Eaton, University of Alabama Birmingham; Mardge H. Cohen, John H Stroger Jr Hospital; Jennifer Cohen, University of California San Francisco; Adebola Adedimeji, Albert Einstein College of Medicine; Michael Plankey, Georgetown University; Deborah Jones, University of Miami; Aruna Chandran, Johns Hopkins Bloomberg; Jonathan Colasanti, Emory University; Anandi Sheth, Emory University
• Language: English
• Date: 2023-01-01
• Publisher: OXFORD UNIV PRESS INC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/ofid/ofac684
• Title of Journal or Parent Work: OPEN FORUM INFECTIOUS DISEASES
• Volume: 10
• Issue: 1
• Start Page: ofac684
• End Page: ofac684
• Grant/Funding Information: MWCCS (Principal Investigators): Atlanta Clinical Research Site (CRS) (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241; Baltimore CRS (Todd Brown and Joseph Margolick), U01-HL146201; Bronx CRS (Kathryn Anastos, David Hanna, and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D'Souza, Stephen Gange and Elizabeth Topper), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Chicago-Northwestern CRS (Steven Wolinsky), U01-HL146240; Northern California CRS (Bradley Aouizerat, Jennifer Price, and Phyllis Tien), U01-HL146242; Los Angeles CRS (Roger Detels and Matthew Mimiaga), U01-HL146333; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146203; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo), U01-HL146208; UAB-MS CRS (Mirjam-Colette Kempf, Jodie Dionne-Odom, and Deborah Konkle-Parker), U01-HL146192; University of North Carolina (UNC) CRS (Adaora Adimora and Michelle Floris-Moore), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute, with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute on Aging, National Institute of Dental and Craniofacial Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Neurological Disorders and Stroke, National Institute of Mental Health, National Institute on Drug Abuse (NIDA), National Institute of Nursing Research, National Cancer Institute, National Institute on Alcohol Abuse and Alcoholism, National Institute on Deafness and Other Communication Disorders, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute on Minority Health and Health Disparities, and in coordination and alignment with the research priorities of the NIH, Office of AIDS Research. MWCCS data collection is also supported by UL1-TR000004 (University of California, San Francisco Clinical and Translational Science Award), UL1-TR003098 (Johns Hopkins University Institute for Clinical and Translational Research), UL1-TR001881 (University of California, Los Angeles Clinical and Translational Science Institute), P30-AI-050409 (Atlanta Center for AIDS Research [CFAR]), P30-AI-073961 (Miami CFAR), P30-AI-050410 (UNC CFAR), P30-AI-027767 (UAB CFAR), and P30-MH-116867 (Miami Center for HIV and Research in Mental Health). A. W. F. is supported by the National Center for Advancing Translational Sciences of the NIH (UL1TR002378 and TL1TR002382) and NIAID (T32AI157855), and also received support from NIDA (R25DA013582). The authors gratefully acknowledge services provided by the Emory CFAR funded through NIAID (P30-AI-050409).
• Keywords: Life Sciences & Biomedicine; BUPRENORPHINE/NALOXONE TREATMENT; OPIOID USE DISORDER; HIV; addiction; DISPARITIES; ABUSE TREATMENT; COHORT; Immunology; substance use; Infectious Diseases; USE DISORDER TREATMENT; CARE; INTERAGENCY HIV; Microbiology; HIV TREATMENT OUTCOMES; DRUG-USE; women; Science & Technology
• Research Categories: Biology, Virology; Health Sciences, Public Health; Health Sciences, Immunology

Abstract

BACKGROUND: Substance use (SU) contributes to poor health outcomes, yet limited data exist to inform strategies to optimize SU treatment among persons with human immunodeficiency virus (HIV). We describe SU and SU treatment utilization among women with and without HIV in the Women's Interagency HIV Study (WIHS). METHODS: We included data from women enrolled in WIHS from 2013 to 2020. Current SU was self-reported, nonmedical use of drugs in the past year, excluding use of only marijuana. SU treatment utilization was self-reported use of a drug treatment program in the past year. Multivariable regression models were used to investigate associations between participant characteristics and SU treatment. RESULTS: Among 2559 women (1802 women living with HIV [WWH], 757 women without HIV), 14% reported current SU. Among those with current SU (n = 367), 71% reported crack/cocaine followed by 40% reporting opioids, and 42% reported any treatment in the past year. The most common treatments were methadone (64%), Narcotics Anonymous (29%), inpatient programs (28%), and outpatient programs (16%). Among women using opioids (n = 147), 67% reported methadone use in the past year compared to 5% using buprenorphine/naloxone. Multivariable analysis showed lower odds of treatment utilization among WWH with concurrent alcohol or marijuana use. Visiting a psychiatrist/counselor was associated with higher odds of treatment. Among WWH, SU treatment was not associated with HIV-related clinical outcomes. CONCLUSIONS: Treatment utilization was high, especially for methadone use. Our results highlight opportunities for accessing SU treatment for WWH, such as the need to prioritize buprenorphine and comprehensive, wraparound services in HIV care settings.