Psychiatric Illness, Substance Use, and Viral Suppression Among HIV-Positive Men of Color Who Have Sex with Men in Los Angeles

被引:33
作者
Aralis, Hilary J. [1 ]
Shoptaw, Steve [2 ,3 ]
Brookmeyer, Ron [1 ]
Ragsdale, Amy [3 ]
Bolan, Robert [4 ]
Gorbach, Pamina M. [5 ,6 ]
机构
[1] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Biostat, 650 Charles E Young Dr South,51-254 CHS, Los Angeles, CA 90095 USA
[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Family Med, Los Angeles, CA 90095 USA
[3] Univ Calif Los Angeles, Ctr HIV Identificat Prevent & Treatment Serv CHIP, Los Angeles, CA USA
[4] Los Angeles LGBT Ctr, Los Angeles, CA USA
[5] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Epidemiol, Los Angeles, CA USA
[6] Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USA
基金
美国国家卫生研究院;
关键词
Minority; MSM; Viral suppression; Psychiatric illness; Cigarette smoking; ANTIRETROVIRAL THERAPY ADHERENCE; MEDICATION ADHERENCE; DRUG-USE; UNITED-STATES; RISK-FACTORS; HEALTH-CARE; LIFE CHAOS; NONADHERENCE; ENGAGEMENT; CASCADE;
D O I
10.1007/s10461-018-2055-z
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
For individuals living with human immunodeficiency virus (HIV), viral suppression positively affects quality and length of life and reduces risks for HIV transmission. Men of color who have sex with men (MoCSM) who have been diagnosed with HIV have disproportionately low rates of viral suppression, with concomitant increases in incidence. We identified specific social, structural, and psychiatric factors associated with viral suppression among a sample of 155 HIV-positive MoCSM. Cigarette smoking and biological markers of recent drug use were significantly associated with detectable viral load. In contrast, individuals reporting a history of psychiatric illness during medical examination were more likely to be virally suppressed. Further analyses demonstrated that psychiatric illness may affect virologic outcomes through increased probability of being prescribed HIV medications. Alternatively, cigarette smoking and drug use appear to negatively affect subsequent HIV Care Continuum milestones such as medication adherence. Findings provide support for comprehensive intervention programs that emphasize prevention and treatment of cigarette, methamphetamine, and other drug use, and promote improved connection to psychiatric care. Continual achievement of this goal may be a crucial step to increase rates of viral suppression and slow HIV incidence in communities of MoCSM in Los Angeles and other urban areas.
引用
收藏
页码:3117 / 3129
页数:13
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