Comorbidities and other consequences at the intersection of the HIV and substance use epidemics

University Of Washington, Seattle WA

Investigators

Linked publications, trials & patents

Abstract

People with HIV (PWH) carry a disproportionate burden of consequences related to substance use and HIV. The goal of this study is to better understand substance use and poor health outcomes among people with HIV (PWH) including substance use patterns, substance use treatment outcomes and HIV-related outcomes including comorbidities such as diabetes. We are particularly interested in those experiencing unstable housing, recently incarcerated, lacking social support, facing HIV-related stigma as well as other subpopulations (many of whom have high rates of substance use) as well as the impacts of use on chronic comorbidities such as diabetes. We will 1. Determine methamphetamine, cocaine and opioid-related behaviors, risk factors, and treatment outcomes to better tailor future intervention/treatment and prevention approaches. We will examine differences in drug-related behaviors including types, frequency, severity of use, mode of administration, polydrug use, overdoses, naloxone access, and substance use treatment access and outcomes. We will determine the role of demographic, behavioral, psychosocial and clinical factors, and incorporate additional biobehavioral measures based on recommendations from community partners, end-users, and critical thought partners to determine risk factors for differences in drug use patterns and substance use treatment outcomes. 2. Determine the role of methamphetamine, cocaine and opioid use in HIV-related outcomes overall and among key subpopulations such as those with unstable housing. We will examine longitudinal relationships between drug use, biobehavioral factors, and HIV care cascade steps such as engagement in care, viral suppression and health-related quality of life. We will determine the impact of drug use and other factors on age-related comorbidities, such as diabetes, frailty, myocardial infarction and chronic kidney disease. We leverage the large well-characterized cohort of PWH with comprehensive clinical data in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. The CNICS patient reported outcomes assessment captures detailed drug use patterns, psychosocial, behavioral and other factors such as social support and housing status. CNICS geocoding and carefully adjudicated clinical outcomes facilitates including biobehavioral and other factors and evaluation of HIV-related comorbidities such as myocardial infarction. CNICS data and our team bring a breadth and depth of resources, responding to RFA-DA-23-061 by generating new knowledge about substance use impacts among PWH and the impact of clinical and other factors. This study will inform future research and assist end-users within our community partnerships in tailoring future substance use treatment programs to the unique needs associated with PWH in order to improve outcomes at the intersection of HIV care and substance use.