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Ament SA, Campbell RR, Lobo MK, Receveur JP, Agrawal K, Borjabad A, Byrareddy SN, Chang L, Clarke D, Emani P, Gabuzda D, Gaulton KJ, Giglio M, Giorgi FM, Gok B, Guda C, Hadas E, Herb BR, Hu W, Huttner A, Ishmam MR, Jacobs MM, Kelschenbach J, Kim DW, Lee C, Liu S, Liu X, Madras BK, Mahurkar AA, Mash DC, Mukamel EA, Niu M, O'Connor RM, Pagan CM, Pang APS, Pillai P, Repunte-Canonigo V, Ruzicka WB, Stanley J, Tickle T, Tsai SYA, Wang A, Wills L, Wilson AM, Wright SN, Xu S, Yang J, Zand M, Zhang L, Zhang J, Akbarian S, Buch S, Cheng CS, Corley MJ, Fox HS, Gerstein M, Gummuluru S, Heiman M, Ho YC, Kellis M, Kenny PJ, Kluger Y, Milner TA, Moore DJ, Morgello S, Ndhlovu LC, Rana TM, Sanna PP, Satterlee JS, Sestan N, Spector SA, Spudich S, Tilgner HU, Volsky DJ, White OR, Williams DW, Zeng H. The single-cell opioid responses in the context of HIV (SCORCH) consortium. Mol Psychiatry 2024:10.1038/s41380-024-02620-7. [PMID: 38879719 DOI: 10.1038/s41380-024-02620-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 05/12/2024] [Accepted: 05/17/2024] [Indexed: 06/19/2024]
Abstract
Substance use disorders (SUD) and drug addiction are major threats to public health, impacting not only the millions of individuals struggling with SUD, but also surrounding families and communities. One of the seminal challenges in treating and studying addiction in human populations is the high prevalence of co-morbid conditions, including an increased risk of contracting a human immunodeficiency virus (HIV) infection. Of the ~15 million people who inject drugs globally, 17% are persons with HIV. Conversely, HIV is a risk factor for SUD because chronic pain syndromes, often encountered in persons with HIV, can lead to an increased use of opioid pain medications that in turn can increase the risk for opioid addiction. We hypothesize that SUD and HIV exert shared effects on brain cell types, including adaptations related to neuroplasticity, neurodegeneration, and neuroinflammation. Basic research is needed to refine our understanding of these affected cell types and adaptations. Studying the effects of SUD in the context of HIV at the single-cell level represents a compelling strategy to understand the reciprocal interactions among both conditions, made feasible by the availability of large, extensively-phenotyped human brain tissue collections that have been amassed by the Neuro-HIV research community. In addition, sophisticated animal models that have been developed for both conditions provide a means to precisely evaluate specific exposures and stages of disease. We propose that single-cell genomics is a uniquely powerful technology to characterize the effects of SUD and HIV in the brain, integrating data from human cohorts and animal models. We have formed the Single-Cell Opioid Responses in the Context of HIV (SCORCH) consortium to carry out this strategy.
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Affiliation(s)
- Seth A Ament
- University of Maryland School of Medicine, Baltimore, MD, USA.
| | | | - Mary Kay Lobo
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | | | | | - Linda Chang
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | - Dana Gabuzda
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | - Michelle Giglio
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | | | - Eran Hadas
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian R Herb
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Wen Hu
- Weill Cornell Medicine, New York, NY, USA
| | | | | | | | | | | | - Cheyu Lee
- University of California Irvine, Irvine, CA, USA
| | - Shuhui Liu
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaokun Liu
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Anup A Mahurkar
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | - Meng Niu
- University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | | | - Piya Pillai
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - W Brad Ruzicka
- McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | | | | | | | - Allen Wang
- University of California San Diego, La Jolla, CA, USA
| | - Lauren Wills
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Siwei Xu
- University of California Irvine, Irvine, CA, USA
| | | | - Maryam Zand
- University of California San Diego, La Jolla, CA, USA
| | - Le Zhang
- Yale School of Medicine, New Haven, CT, USA
| | - Jing Zhang
- University of California Irvine, Irvine, CA, USA
| | | | - Shilpa Buch
- University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | - Howard S Fox
- University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | - Myriam Heiman
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Ya-Chi Ho
- Yale School of Medicine, New Haven, CT, USA
| | - Manolis Kellis
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Paul J Kenny
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - David J Moore
- University of California San Diego, La Jolla, CA, USA
| | - Susan Morgello
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Tariq M Rana
- University of California San Diego, La Jolla, CA, USA
| | | | | | | | | | | | | | - David J Volsky
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Owen R White
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Hongkui Zeng
- Allen Institute for Brain Science, Seattle, WA, USA
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Ware OD, Srivastava A, Masa R, Baca-Atlas SN, Chowa G. HIV Prevention Services in Residential Substance Use Disorder Treatment Facilities in the United States. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:173-183. [PMID: 37129590 DOI: 10.1521/aeap.2023.35.2.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Residential substance use disorder treatment is designed to treat more severe substance use disorders. Considering the strong association between substance use and HIV, providing HIV prevention services during residential substance use disorder treatment is imperative. However, not all treatment facilities offer the same services, and differences in residential substance use disorder treatment facilities providing HIV prevention services might stem from facility-level characteristics. Using 3 years (2018-2020) of cross-sectional data from the National Survey of Substance Abuse Treatment Services, we examined which treatment facility characteristics were associated with having HIV prevention services. Using a logistic regression model with HIV prevention services as the outcome, we found that facilities that were accredited, engaged in community outreach, and offered assistance with housing and transportation were more likely to provide HIV prevention services. Furthermore, facilities in the Midwest and West were less likely to provide HIV prevention services than those in the South.
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Affiliation(s)
- Orrin D Ware
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, North Carolina
| | - Ankur Srivastava
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, North Carolina
| | - Rainier Masa
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, North Carolina
| | - Stefani N Baca-Atlas
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, North Carolina
| | - Gina Chowa
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, North Carolina
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Taylor SW, McKetchnie SM, Batchelder AW, Justice A, Safren SA, O’Cleirigh C. Chronic pain and substance use disorders among older sexual minority men living with HIV: Implications for HIV disease management across the HIV care continuum. AIDS Care 2023; 35:614-623. [PMID: 35653300 PMCID: PMC9715850 DOI: 10.1080/09540121.2022.2076801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
Abstract
HIV continues to be a critical health issue for sexual minority men (SMM) in the USA. Chronic pain is common in individuals with HIV, including older SMM, and is associated with substance use behaviors. This cross-sectional study sought to address a gap in the literature by characterizing interrelationships among chronic pain, substance use disorders (SUDs), medication adherence, and engagement in HIV care among older (≥50) SMM living with HIV and chronic pain (N = 63). The unadjusted relationship between an opioid use disorder and pain indicated that participants with an opioid use disorder reported higher pain ratings than those without. Presence of alcohol use disorder was significantly associated with missed HIV-care appointments due to chronic pain or substance use, showing that individuals with an alcohol use disorder reported more missed appointments in the past year. Higher pain was significantly associated with the same missed appointments variable, such that those reporting higher pain ratings also reported more missed appointments in the past year. These findings provide preliminary evidence of the interrelationships among chronic pain, SUDs, and engagement in HIV care among older SMM living with HIV and suggest that pain management in this population might support fuller engagement in HIV care.
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Affiliation(s)
- S. Wade Taylor
- Boston University School of Social Work, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Samantha M. McKetchnie
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Abigail W. Batchelder
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Amy Justice
- Department of Internal Medicine, Yale University, New Haven, CT, USA
| | - Steven A. Safren
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Conall O’Cleirigh
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Zabel M, Wilson TW, Sayles H, May PE, Furl R, Bares SH. The Impact of the COVID-19 Pandemic on Mental Health and Substance Use among People with and without HIV. Pathogens 2023; 12:461. [PMID: 36986383 PMCID: PMC10051668 DOI: 10.3390/pathogens12030461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/03/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
People with HIV (PWH) may be particularly vulnerable to the psychological impacts of COVID-19. To assess this, participants were recruited from two established cohorts of PWH and HIV- adults with the available pre-pandemic baseline data and completed the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Alcohol Use Identification Test (AUDIT), National Institute on Drug Abuse Quick Screen (NIDA-QS), and Pittsburgh Sleep Quality Index (PSQI) at two distinct intra-pandemic time periods. All outcomes were evaluated using generalized linear mixed models. In total, 87 participants completed all the questionnaires; 45 were PWH and 42 were HIV-. The pre-pandemic mean BDI-II, BAI, AUDIT and PSQI scores were higher in the PWH cohort. After the onset of the pandemic, the mean BDI-II, AUDIT and PSQI scores increased within the sample as a whole (p < 0.001, p = 0.029 and p = 0.046, respectively). The intra-pandemic mean BDI-II scores fell slightly for both groups and the AUDIT scores increased slightly for the PWH group and fell slightly for the HIV- group, but not significantly. The intra-pandemic PSQI scores increased sharply for both groups. The percentage of PWH and HIV- participants who moved into a more severe category of depression was identical (18%), but more PWH met the criteria for clinical evaluation. The BAI and NIDA-QS scores did not increase significantly. In conclusion, the measures of mental health symptoms and alcohol use increased in both groups after the onset of the pandemic. Although there were no significant differences in the changes between the groups, the PWH had higher baseline scores and the changes in this group had more clinical impacts.
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Affiliation(s)
- Morgan Zabel
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA
| | - Harlan Sayles
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Pamela E. May
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Renae Furl
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Sara H. Bares
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Martinez SS, Stebliankin V, Hernandez J, Martin H, Tamargo J, Rodriguez JB, Teeman C, Johnson A, Seminario L, Campa A, Narasimhan G, Baum MK. Multiomic analysis reveals microbiome-related relationships between cocaine use and metabolites. AIDS 2022; 36:2089-2099. [PMID: 36382433 PMCID: PMC9673179 DOI: 10.1097/qad.0000000000003363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Over 19 million individuals globally have a cocaine use disorder, a significant public health crisis. Cocaine has also been associated with a pro-inflammatory state and recently with imbalances in the intestinal microbiota as compared to nonuse. The objective of this pilot study was to characterize the gut microbiota and plasma metabolites in people with HIV (PWH) who use cocaine compared with those who do not. DESIGN Cross-sectional study. METHODS A pilot study in PWH was conducted on 25 cocaine users and 25 cocaine nonusers from the Miami Adult Studies on HIV cohort. Stool samples and blood plasma were collected. Bacterial composition was characterized using 16S rRNA sequencing. Metabolomics in plasma were determined using gas and liquid chromatography/mass spectrometry. RESULTS The relative abundances of the Lachnopspira genus, Oscillospira genus, Bifidobacterium adolescentis species, and Euryarchaeota phylum were significantly higher in the cocaine- using PWH compared to cocaine-nonusing PWH. Cocaine-use was associated with higher levels of several metabolites: products of dopamine catabolism (3-methoxytyrosine and 3-methoxytyramine sulfate), phenylacetate, benzoate, butyrate, and butyrylglycine. CONCLUSIONS Cocaine use was associated with higher abundances of taxa and metabolites known to be associated with pathogenic states that include gastrointestinal conditions. Understanding key intestinal bacterial functional pathways that are altered due to cocaine use in PWH will provide a better understanding of the relationships between the host intestinal microbiome and potentially provide novel treatments to improve health.
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Affiliation(s)
| | - Vitalii Stebliankin
- Florida International University, Bioinformatics Research Group (BioRG), Miami, FL, USA
| | - Jacqueline Hernandez
- Florida International University, R. Stempel College of Public Health and Social Work
| | - Haley Martin
- Florida International University, R. Stempel College of Public Health and Social Work
| | - Javier Tamargo
- Florida International University, R. Stempel College of Public Health and Social Work
| | | | - Colby Teeman
- Florida International University, R. Stempel College of Public Health and Social Work
| | - Angelique Johnson
- Florida International University, R. Stempel College of Public Health and Social Work
| | - Leslie Seminario
- Florida International University, R. Stempel College of Public Health and Social Work
| | - Adriana Campa
- Florida International University, R. Stempel College of Public Health and Social Work
| | - Giri Narasimhan
- Florida International University, Bioinformatics Research Group (BioRG), Miami, FL, USA
| | - Marianna K Baum
- Florida International University, R. Stempel College of Public Health and Social Work
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Peprah E, Myers B, Kengne AP, Peer N, El-Shahawy O, Ojo T, Mukasa B, Ezechi O, Iwelunmor J, Ryan N, Sakho F, Patena J, Gyamfi J. Using a Syndemics Framework to Understand How Substance Use Contributes to Morbidity and Mortality among People Living with HIV in Africa: A Call to Action. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031097. [PMID: 35162121 PMCID: PMC8834153 DOI: 10.3390/ijerph19031097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 02/04/2023]
Abstract
Substance use is increasing throughout Africa, with the prevalence of alcohol, tobacco, cannabis, and other substance use varying regionally. Concurrently, sub-Saharan Africa bears the world’s largest HIV burden, with 71% of people living with HIV (PWH) living in Africa. Problematic alcohol, tobacco, and other substance use among PWH is associated with multiple vulnerabilities comprising complex behavioral, physiological, and psychological pathways that include high-risk behaviors (e.g., sexual risk-taking), HIV disease progression, and mental health problems, all of which contribute to nonadherence to antiretroviral therapy. Physiologically, severe substance use disorders are associated with increased levels of biological markers of inflammation; these, in turn, are linked to increased mortality among PWH. The biological mechanisms that underlie the increased risk of substance use among PWH remain unclear. Moreover, the biobehavioral mechanisms by which substance use contributes to adverse health outcomes are understudied in low- and middle-income countries (LMIC). Syndemic approaches to understanding the co-occurrence of substance use and HIV have largely been limited to high-income countries. We propose a syndemic coupling conceptual model to disentangle substance use from vulnerabilities to elucidate underlying disease risk for PWH. This interventionist perspective enables assessment of biobehavioral mechanisms and identifies malleable targets of intervention.
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Affiliation(s)
- Emmanuel Peprah
- Global Health Program, New York University School of Global Public Health, New York, NY 10003, USA; (O.E.-S.); (T.O.); (N.R.); (F.S.); (J.P.); (J.G.)
- Correspondence:
| | - Bronwyn Myers
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia;
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
- Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7925, South Africa
| | - Andre-Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (A.-P.K.); (N.P.)
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (A.-P.K.); (N.P.)
| | - Omar El-Shahawy
- Global Health Program, New York University School of Global Public Health, New York, NY 10003, USA; (O.E.-S.); (T.O.); (N.R.); (F.S.); (J.P.); (J.G.)
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
- Center for the Prevention of Heart Disease, John Hopkins Hospital, Baltimore, MD 21287, USA
| | - Temitope Ojo
- Global Health Program, New York University School of Global Public Health, New York, NY 10003, USA; (O.E.-S.); (T.O.); (N.R.); (F.S.); (J.P.); (J.G.)
| | | | - Oliver Ezechi
- Nigerian Institute of Medical Research, Yaba, Lagos 101245, Nigeria;
| | - Juliet Iwelunmor
- College for Public Health and Social Justice, Department of Behavioral Science and Health Education, Saint Louis University, St. Louis, MO 63104, USA;
| | - Nessa Ryan
- Global Health Program, New York University School of Global Public Health, New York, NY 10003, USA; (O.E.-S.); (T.O.); (N.R.); (F.S.); (J.P.); (J.G.)
| | - Fatoumata Sakho
- Global Health Program, New York University School of Global Public Health, New York, NY 10003, USA; (O.E.-S.); (T.O.); (N.R.); (F.S.); (J.P.); (J.G.)
| | - John Patena
- Global Health Program, New York University School of Global Public Health, New York, NY 10003, USA; (O.E.-S.); (T.O.); (N.R.); (F.S.); (J.P.); (J.G.)
| | - Joyce Gyamfi
- Global Health Program, New York University School of Global Public Health, New York, NY 10003, USA; (O.E.-S.); (T.O.); (N.R.); (F.S.); (J.P.); (J.G.)
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7
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Diaz-Martinez J, Tamargo JA, Delgado-Enciso I, Liu Q, Acuña L, Laverde E, Barbieri MA, Trepka MJ, Campa A, Siminski S, Gorbach PM, Baum MK. Resilience, Anxiety, Stress, and Substance Use Patterns During COVID-19 Pandemic in the Miami Adult Studies on HIV (MASH) Cohort. AIDS Behav 2021; 25:3658-3668. [PMID: 34009479 PMCID: PMC8132028 DOI: 10.1007/s10461-021-03292-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 01/11/2023]
Abstract
We evaluated mental health and substance use during the COVID-19 pandemic in 196 participants from the Miami Adult Studies on HIV (MASH) Cohort. A survey was administered between July-August of 2020, including validated measures of resilience and anxiety, a scale to measure COVID-19-related worry, and self-reported substance use. Compared to HIV-uninfected participants (n = 80), those living with HIV (n = 116) reported fewer anxiety symptoms, less COVID-19-related worry, and higher resilience. Those with more anxiety symptoms and lower resilience engaged in more frequent alcohol consumption, binge drinking, and cocaine use. Alcohol misuse was more common among HIV-uninfected participants. Cocaine use was reported by 21% fewer participants during the pandemic compared with 7.3 ± 1.5 months earlier. Possibly due to their experiences with HIV, PLWH responded with higher resilience and reduced worry and anxiety to the adversities brought by the COVID-19 pandemic.
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Affiliation(s)
- Janet Diaz-Martinez
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Javier A Tamargo
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | | | - Qingyun Liu
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Leonardo Acuña
- College of Arts, Sciences & Education, Florida International University, Miami, FL, USA
| | - Eduardo Laverde
- College of Arts, Sciences & Education, Florida International University, Miami, FL, USA
| | - Manuel A Barbieri
- College of Arts, Sciences & Education, Florida International University, Miami, FL, USA
| | - Mary Jo Trepka
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Adriana Campa
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | | | - Pamina M Gorbach
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Marianna K Baum
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA.
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8
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Sevelius JM, Xavier J, Chakravarty D, Keatley J, Shade S, Rebchook G. Correlates of Engagement in HIV Care Among Transgender Women of Color in the United States of America. AIDS Behav 2021; 25:3-12. [PMID: 34037930 PMCID: PMC10204129 DOI: 10.1007/s10461-021-03306-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 11/30/2022]
Abstract
HIV prevalence among transgender women of color (TWC) in the United States of America is high. We enrolled TWC living with HIV (N = 858) to evaluate 1nine HIV care interventions. We examined factors associated with four outcomes at enrollment: linkage to care, ever being on antiretroviral treatment, retention in care and viral suppression. The sample was 49% Hispanic/Latino, 42% Black; average age was 37 years; 77% were ever linked to care, 36% were ever on treatment, 22% were retained in care, and 36% were virally suppressed. Current hormone use was significantly associated with linkage, retention, and viral suppression (all aORs > 1.5), providing evidence for gender-affirming care as an important facilitator of engagement in HIV care. Greater health care empowerment was significantly associated with greater odds of all outcomes (aORs between 1.19 and 1.37). These findings identify potential intervention targets to improve the provision of care and treatment for TWC living with HIV.
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Affiliation(s)
- Jae M Sevelius
- Center for AIDS Prevention Studies, Department of Medicine, University of California, UCSF/CAPS, 550 16th Street, 3rd floor, San Francisco, CA, 94158, USA.
- Center of Excellence for Transgender Health, Department of Medicine, University of California, San Francisco, CA, USA.
| | | | - Deepalika Chakravarty
- Center for AIDS Prevention Studies, Department of Medicine, University of California, UCSF/CAPS, 550 16th Street, 3rd floor, San Francisco, CA, 94158, USA
| | - JoAnne Keatley
- Innovative Response Globally for Transgender Women and HIV (IRGT), San Francisco, CA, USA
| | - Starley Shade
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
| | - Greg Rebchook
- Center for AIDS Prevention Studies, Department of Medicine, University of California, UCSF/CAPS, 550 16th Street, 3rd floor, San Francisco, CA, 94158, USA
- Center of Excellence for Transgender Health, Department of Medicine, University of California, San Francisco, CA, USA
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9
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Meade CS, Towe SL, Xu Y, Rainer C. HIV Prevalence and Associated Risks in a Respondent-Driven Sample of Illicit Stimulant Users in a Southern United States City. AIDS Behav 2020; 24:2336-2346. [PMID: 31960197 PMCID: PMC7369231 DOI: 10.1007/s10461-020-02793-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Stimulant abuse is a major contributor to HIV transmission in the United States, yet HIV prevalence among persons who use illicit stimulants remains unknown. We implemented respondent driven sampling (RDS) to estimate the prevalence of HIV infection in this high-risk population. We also examined RDS-adjusted rates of risk behaviors among HIV-positive and HIV-negative participants. Recruited from seven seeds, our sample of 387 participants was 46% female, 89% African American, and 45.94 years old on average. Participants were predominantly non-injection cocaine users, had large networks of stimulant users, and reported an established relationship with their recruiter. The adjusted population proportion of HIV infection was 0.07 (0.04, 0.11). The majority of sexually active participants reported engagement in risk behaviors (73%), but rates generally did not differ by HIV status. Our results highlight that stimulant use is a risk factor for HIV infection. This study also demonstrates that RDS is a very effective strategy for reaching stimulant users in the community.
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Affiliation(s)
- Christina S Meade
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA.
| | - Sheri L Towe
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA
| | - Yunan Xu
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA
| | - Crissi Rainer
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA
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The Mediating Role of Depressive Symptoms in the Association Between Food Insecurity and HIV Related Health Outcomes Among HIV-HCV Co-Infected People. AIDS Behav 2020; 24:2188-2194. [PMID: 31950306 DOI: 10.1007/s10461-020-02784-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Food insecurity may lead to depressive symptoms, which are known to be associated with poor HIV related health outcomes. However, it is unclear to what extent food insecurity 'directly' affects these outcomes. We used data from the Food Security & HIV-HCV Sub-Study of the Canadian Co-Infection Cohort to assess the controlled direct effect. People experiencing severe food insecurity had 1.47 (95% CI 1.04-2.09) times the risk of having detectable HIV viral load and 0.94 (95% CI 0.87-1.02) fold change in CD4 count. After holding depressive symptoms constant, the association between severe food insecurity and HIV viral load was attenuated to a statistically non-significant level (RR 1.36, 95% CI: 0.95-1.96), whereas the association between severe food insecurity and CD4 count was unchanged. Depressive symptoms partially mediate the effect of severe food insecurity on HIV viral suppression; interventions focused on depressive symptoms alone may not be sufficient, however, to eliminate this effect.
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Aung HL, Kootar S, Gates TM, Brew BJ, Cysique LA. How all-type dementia risk factors and modifiable risk interventions may be relevant to the first-generation aging with HIV infection? Eur Geriatr Med 2019; 10:227-238. [DOI: 10.1007/s41999-019-00164-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 01/09/2019] [Indexed: 11/24/2022]
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