nach oben

25.04.2024 | Original Paper

Prevalence and Correlates of Heavy Alcohol use among People Living with HIV who use Unregulated Drugs in Vancouver, Canada

verfasst von: Jeremy Hui, Hudson Reddon, Nadia Fairbairn, JinCheol Choi, M-J Milloy, Maria Eugenia Socias

Einloggen, um Zugang zu erhalten

Abstract

Among people living with HIV (PLWH), heavy alcohol use is associated with many negative health consequences. However, the impacts of heavy alcohol use are not well described for PLWH who use drugs. Thus, we investigated the prevalence and correlates of heavy alcohol use among a cohort of people who use drugs (PWUD) living with HIV in Vancouver, Canada. We accessed data from an ongoing community-recruited prospective cohort of PLWH who use drugs with linked comprehensive HIV clinical monitoring data. We used generalized linear mixed-effects modeling to identify factors longitudinally associated with periods of heavy alcohol use between December 2005 and December 2019. Of the 896 participants included, 291 (32.5%) reported at least one period with heavy alcohol use. Periods of recent incarceration (Adjusted Odds Ratio [AOR] = 1.48, 95% Confidence Interval [CI]: 1.01–2.17), encounters with police (AOR = 1.87, 95% CI: 1.37–2.56), and older age (AOR = 1.05, 95% CI: 1.02–1.07) were positively associated with heavy alcohol use. Engagement in drug or alcohol treatment (AOR = 0.54, 95% CI: 0.42–0.70) and male gender (AOR = 0.46; 95% CI: 0.27–0.78) were negatively associated with heavy alcohol use. We observed that heavy alcohol use was clearly linked to involvement with the criminal justice system. These findings, together with the protective effects of substance use treatment, suggest the need to expand access for drug and alcohol treatment programs overall, and in particular through the criminal justice system to reduce alcohol-related harms among PLWH who use drugs.

GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2018;392:1015–35.PubMedCentralCrossRef

Giordano TP, Visnegarwala F, White AC, Troisi CL, Frankowski RF, Hartman CM, et al. Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure. AIDS Care. 2005;17:773–83.PubMedCrossRef

Amirkhanian YA, Kelly JA, DiFranceisco WJ, Kuznetsova AV, Tarima SS, Yakovlev AA, et al. Predictors of HIV Care Engagement, antiretroviral medication adherence, and viral suppression among people living with HIV infection in St. Petersburg, Russia. AIDS Behav. 2018;22:791–9.PubMedPubMedCentralCrossRef

Hendershot CS, Stoner SA, Pantalone DW, Simoni JM. Alcohol use and antiretroviral adherence: review and meta-analysis. J Acquir Immune Defic Syndr. 2009;52:180–202.PubMedPubMedCentralCrossRef

Chander G, Lau B, Moore RD. Hazardous alcohol use: a risk factor for non-adherence and lack of suppression in HIV infection. J Acquir Immune Defic Syndr. 2006;43:411–7.PubMedPubMedCentralCrossRef

Baum MK, Rafie C, Lai S, Sales S, Page JB, Campa A. Alcohol use accelerates HIV disease progression. AIDS Res Hum Retroviruses. 2010;26:511–8.PubMedPubMedCentralCrossRef

Wu ES, Metzger DS, Lynch KG, Douglas SD. Association between alcohol use and HIV viral load. J Acquir Immune Defic Syndr. 2011;56:e129–130.PubMedPubMedCentralCrossRef

Marshall BDL, Tate JP, McGinnis KA, Bryant KJ, Cook RL, Edelman EJ, et al. Long-term alcohol use patterns and HIV disease severity. AIDS. 2017;31:1313–21.PubMedCrossRef

Stein MD, Hanna L, Natarajan R, Clarke J, Marisi M, Sobota M, et al. Alcohol use patterns predict high-risk HIV behaviors among active injection drug users. J Subst Abuse Treat. 2000;18:359–63.PubMedCrossRef

10.

Arasteh K, Des Jarlais DC. At-risk drinking and injection and sexual risk behaviors of HIV-positive injection drug users entering drug treatment in New York City. AIDS Patient Care STDS. 2009;23:657–61.PubMedPubMedCentralCrossRef

11.

Le Marchand C, Evans J, Page K, Davidson PJ, Hahn JA. Hazardous alcohol consumption among young adult IDU and its association with high risk behaviors. Drug Alcohol Depend. 2013;127:143–9.PubMedCrossRef

12.

Fairbairn N, Wood E, Dong H, Kerr T, DeBeck K. Unsafe sexual behaviour associated with hazardous alcohol use among street-involved youth. AIDS Care. 2017;29:481–8.PubMedCrossRef

13.

Fairbairn N, Hayashi K, Milloy M-J, Nolan S, Nguyen P, Wood E, et al. Hazardous alcohol use associated with increased sexual risk behaviors among people who inject drugs. Alcohol Clin Exp Res. 2016;40:2394–400.PubMedPubMedCentralCrossRef

14.

Marshall BDL, Fairbairn N, Li K, Wood E, Kerr T. Physical violence among a prospective cohort of injection drug users: a gender-focused approach. Drug Alcohol Depend. 2008;97:237–46.PubMedPubMedCentralCrossRef

15.

Dietze P, Jenkinson R, Aitken C, Stoové M, Jolley D, Hickman M, et al. The relationship between alcohol use and injecting drug use: impacts on health, crime and wellbeing. Drug Alcohol Depend. 2013;128:111–5.PubMedCrossRef

16.

Klimas J, Nosova E, Socías E, Nolan S, Brar R, Hayashi K, et al. Factors associated with discontinuation of methadone maintenance therapy (MMT) among persons who use alcohol in Vancouver, Canada. Drug Alcohol Depend. 2018;186:182–6.PubMedPubMedCentralCrossRef

17.

Young SV, Wood E, Dong H, Kerr T, Hayashi K. Daily alcohol use as an independent risk factor for HIV seroconversion among people who inject drugs. Addiction. 2016;111:1360–5.PubMedPubMedCentralCrossRef

18.

Johnson C, Dong H, Ahamad K, Hayashi K, Milloy MJ, Kerr T, et al. Impact of binge alcohol on mortality among people who inject drugs. Addict Behav Rep. 2015;2:28–32.PubMedPubMedCentral

19.

Palepu A, Tyndall MW, Li K, Yip B, O’Shaughnessy MV, Schechter MT, et al. Alcohol use and incarceration adversely affect HIV-1 RNA suppression among injection drug users starting antiretroviral therapy. J Urban Health. 2003;80:667–75.PubMedPubMedCentralCrossRef

20.

Fairbairn NS, Walley AY, Cheng DM, Quinn E, Bridden C, Chaisson C, et al. Mortality in HIV-Infected alcohol and drug users in St. Petersburg, Russia. PLoS ONE. 2016;11:e0166539.PubMedPubMedCentralCrossRef

21.

Khan MR, McGinnis KA, Grov C, Scheidell JD, Hawks L, Edelman EJ, et al. Past year and prior incarceration and HIV transmission risk among HIV-positive men who have sex with men in the US. AIDS Care. 2019;31:349–56.PubMedCrossRef

22.

Bazzi AR, Drainoni M-L, Biancarelli DL, Hartman JJ, Mimiaga MJ, Mayer KH, et al. Systematic review of HIV treatment adherence research among people who inject drugs in the United States and Canada: evidence to inform pre-exposure prophylaxis (PrEP) adherence interventions. BMC Public Health. 2019;19:31.PubMedPubMedCentralCrossRef

23.

Wang EA, McGinnis KA, Long JB, Akgün KM, Edelman EJ, Rimland D, et al. Incarceration and health outcomes in HIV-infected patients: the impact of substance use, primary care engagement, and antiretroviral adherence. Am J Addict. 2015;24:178–84.PubMedPubMedCentralCrossRef

24.

BC Coroners Service. Unregulated Drug Deaths in B.C. (to June 30, 2023) [Internet]. Province of British Columbia; [cited 2023 Jul 20]. https://www2.gov.bc.ca/gov/content/life-events/death/coroners-service/statistical-reports

25.

Small W, Maher L, Lawlor J, Wood E, Shannon K, Kerr T. Injection drug users’ involvement in drug dealing in the downtown eastside of Vancouver: social organization and systemic violence. Int J Drug Policy. 2013;24:479–87.PubMedPubMedCentralCrossRef

26.

Linden IA, Mar MY, Werker GR, Jang K, Krausz M. Research on a vulnerable neighborhood-the Vancouver downtown eastside from 2001 to 2011. J Urban Health. 2013;90:559–73.PubMedCrossRef

27.

Burnett K. Commodifying poverty: gentrification and consumption in Vancouver’s downtown Eastside. Urban Geogr. 2014;35:157–76.CrossRef

28.

Wood E, Hogg RS, Lima VD, Kerr T, Yip B, Marshall BDL, et al. Highly active antiretroviral therapy and survival in HIV-infected injection drug users. JAMA. 2008;300:550–4.PubMedCrossRef

29.

Rethinking Drinking | NIAAA [Internet]. [cited 2023 Apr 25]. https://www.rethinkingdrinking.niaaa.nih.gov/

30.

Kranzler HR, Soyka M. Diagnosis and pharmacotherapy of alcohol use disorder: a review. JAMA. 2018;320:815–24.PubMedPubMedCentralCrossRef

31.

Cao Y, Giovannucci EL. Alcohol as a risk factor for Cancer. Semin Oncol Nurs. 2016;32:325–31.PubMedCrossRef

32.

Crabb DW, Im GY, Szabo G, Mellinger JL, Lucey MR. Diagnosis and treatment of alcohol-associated liver diseases: 2019 practice guidance from the American association for the study of liver diseases. Hepatology. 2020;71:306–33.PubMedCrossRef

33.

Piano MR, Mazzuco A, Kang M, Phillips SA. Cardiovascular consequences of binge drinking: an integrative review with implications for advocacy, policy, and research. Alcohol Clin Exp Res. 2017;41:487–96.PubMedPubMedCentralCrossRef

34.

Prangnell A, Nosova E, Milloy M-J, Wood E, Hayashi K. The relationship between parental heavy drinking and non-fatal overdose among people who inject drugs in Vancouver, Canada. Addict Behav. 2019;89:224–8.PubMedCrossRef

35.

Klimas J, Wood E, Nguyen P, Dong H, Milloy MJ, Kerr T, et al. The impact of Enrolment in methadone maintenance therapy on initiation of heavy drinking among people who use Heroin. Eur Addict Res. 2016;22:210–4.PubMedCrossRef

36.

Socías ME, Wood E, Kerr T, Nolan S, Hayashi K, Nosova E et al. Trends in engagement in the cascade of care for opioid use disorder, Vancouver, Canada, 2006–2016. Drug Alcohol Depend. 2018;189:90–5.

37.

Liang J, Nosova E, Reddon H, Nolan S, Socías E, Barrios R, et al. Longitudinal patterns of illicit drug use, antiretroviral therapy exposure and plasma HIV-1 RNA viral load among HIV-positive people who use illicit drugs. AIDS. 2020;34:1389–96.PubMedCrossRef

38.

Ladak F, Socias E, Nolan S, Dong H, Kerr T, Wood E, et al. Substance use patterns and HIV-1 RNA viral load rebound among HIV-positive illicit drug users in a Canadian setting. Antivir Ther. 2019;24:19–25.PubMedPubMedCentralCrossRef

39.

Serdar CC, Cihan M, Yücel D, Serdar MA. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochem Med (Zagreb). 2021;31:010502.PubMedCrossRef

40.

Reddon H, Fast D, DeBeck K, Werb D, Hayashi K, Wood E, et al. Prevalence and correlates of selling illicit cannabis among people who use drugs in Vancouver, Canada: a ten-year prospective cohort study. Int J Drug Policy. 2019;69:16–23.PubMedPubMedCentralCrossRef

41.

Obradovic M, Lal A, Liedgens H. Validity and responsiveness of EuroQol-5 dimension (EQ-5D) versus short Form-6 dimension (SF-6D) questionnaire in chronic pain. Health Qual Life Outcomes. 2013;11:110.PubMedPubMedCentralCrossRef

42.

Tran BX, Dang AK, Truong NT, Ha GH, Nguyen HLT, Do HN, et al. Depression and quality of life among patients living with HIV/AIDS in the era of universal treatment access in Vietnam. Int J Environ Res Public Health. 2018;15:2888.PubMedPubMedCentralCrossRef

43.

Lake S, Walsh Z, Kerr T, Cooper ZD, Buxton J, Wood E, et al. Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: a longitudinal analysis. PLoS Med. 2019;16:e1002967.PubMedPubMedCentralCrossRef

44.

Sangsari S, Milloy M-J, Ibrahim A, Kerr T, Zhang R, Montaner J, et al. Physician experience and rates of plasma HIV-1 RNA suppression among illicit drug users: an observational study. BMC Infect Dis. 2012;12:22.PubMedPubMedCentralCrossRef

45.

Tapp C, Milloy M-J, Kerr T, Zhang R, Guillemi S, Hogg RS, et al. Female gender predicts lower access and adherence to antiretroviral therapy in a setting of free healthcare. BMC Infect Dis. 2011;11:86.PubMedPubMedCentralCrossRef

46.

Fovet T, Wathelet M, Benbouriche M, Benradia I, Roelandt J-L, Thomas P, et al. Substance Use, Substance Use disorders, and Co-occurring Psychiatric disorders in recently incarcerated men: a comparison with the General Population. Eur Addict Res. 2022;28:368–76.PubMedCrossRef

47.

Azbel L, Wickersham JA, Grishaev Y, Dvoryak S, Altice FL. Burden of infectious diseases, substance use disorders, and mental illness among Ukrainian prisoners transitioning to the community. PLoS ONE. 2013;8:e59643.PubMedPubMedCentralCrossRef

48.

Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG, et al. Release from prison–a high risk of death for former inmates. N Engl J Med. 2007;356:157–65.PubMedPubMedCentralCrossRef

49.

Madkour AS, Felker-Kantor E, Welsh DA, Molina PE, Theall KP, Ferguson T. Lifetime Alcohol Use Trajectories and Health Status among persons living with HIV (PLWH). J Stud Alcohol Drugs. 2022;83:695–703.PubMedPubMedCentralCrossRef

50.

Seal DW, Eldrige GD, Kacanek D, Binson D, Macgowan RJ, Project START Study Group. A longitudinal, qualitative analysis of the context of substance use and sexual behavior among 18- to 29-year-old men after their release from prison. Soc Sci Med. 2007;65:2394–406.PubMedCrossRef

51.

English D, Carter JA, Bowleg L, Malebranche DJ, Talan AJ, Rendina HJ. Intersectional social control: the roles of incarceration and police discrimination in psychological and HIV-related outcomes for black sexual minority men. Soc Sci Med. 2020;258:113121.PubMedPubMedCentralCrossRef

52.

Beletsky L, Heller D, Jenness SM, Neaigus A, Gelpi-Acosta C, Hagan H. Syringe access, syringe sharing, and police encounters among people who inject drugs in New York City: a community-level perspective. Int J Drug Policy. 2014;25:105–11.PubMedCrossRef

53.

Sørensen HJ, Manzardo A, Just-Østergaard E, Penick EC, Becker UMD, Mortensen EL, et al. Young adult predictors of alcohol dependence to age 53: a 44-year prospective cohort study of Danish men. Addiction. 2021;116:780–7.PubMedCrossRef

54.

Jacob Arriola KR, Braithwaite RL, Holmes E, Fortenberry RM. Post-release case management services and health-seeking behavior among HIV-infected ex-offenders. J Health Care Poor Underserved. 2007;18:665–74.PubMedCrossRef

55.

Olgin GK, Bórquez A, Baker P, Clairgue E, Morales M, Bañuelos A, et al. Preferences and acceptability of law enforcement initiated referrals for people who inject drugs: a mixed methods analysis. Subst Abuse Treat Prev Policy. 2020;15:75.PubMedPubMedCentralCrossRef

56.

Go VF, Hutton HE, Ha TV, Chander G, Latkin CA, Mai NVT, et al. Effect of 2 Integrated Interventions on Alcohol Abstinence and viral suppression among Vietnamese adults with Hazardous Alcohol Use and HIV: a Randomized Clinical Trial. JAMA Netw Open. 2020;3:e2017115.PubMedPubMedCentralCrossRef

57.

Springer SA, Di Paola A, Barbour R, Azar MM, Altice FL. Extended-release Naltrexone improves viral suppression among incarcerated persons living with HIV and Alcohol use disorders transitioning to the community: results from a Double-Blind, placebo-controlled trial. J Acquir Immune Defic Syndr. 2018;79:92–100.PubMedPubMedCentralCrossRef

58.

Springer SA, Di Paola A, Azar MM, Barbour R, Krishnan A, Altice FL. Extended-release naltrexone reduces alcohol consumption among released prisoners with HIV disease as they transition to the community. Drug Alcohol Depend. 2017;174:158–70.PubMedPubMedCentralCrossRef

59.

Chokron Garneau H, Venegas A, Rawson R, Ray LA, Glasner S. Barriers to initiation of extended release naltrexone among HIV-infected adults with alcohol use disorders. J Subst Abuse Treat. 2018;85:34–7.PubMedCrossRef

60.

Chander G, Monroe AK, Crane HM, Hutton HE, Saag MS, Cropsey K, et al. HIV primary care providers–Screening, knowledge, attitudes and behaviors related to alcohol interventions. Drug Alcohol Depend. 2016;161:59–66.PubMedPubMedCentralCrossRef

61.

Hu X, Harman J, Winterstein AG, Zhong Y, Wheeler AL, Taylor TN, et al. Utilization of Alcohol Treatment among HIV-Positive women with Hazardous drinking. J Subst Abuse Treat. 2016;64:55–61.PubMedPubMedCentralCrossRef

62.

Conen A, Fehr J, Glass TR, Furrer H, Weber R, Vernazza P, et al. Self-reported alcohol consumption and its association with adherence and outcome of antiretroviral therapy in the Swiss HIV Cohort Study. Antivir Ther. 2009;14:349–57.PubMedCrossRef

63.

Gurung S, Ventuneac A, Cain D, Mirzayi C, Ferraris C, Rendina HJ, et al. Alcohol and substance use diagnoses among HIV-positive patients receiving care in NYC clinic settings. Drug Alcohol Depend. 2017;180:62–7.PubMedPubMedCentralCrossRef

64.

Breslow RA, Castle I-JP, Chen CM, Graubard BI. Trends in Alcohol Consumption among Older americans: National Health Interview Surveys, 1997 to 2014. Alcohol Clin Exp Res. 2017;41:976–86.PubMedPubMedCentralCrossRef

65.

Xu Q, Ou X, Li J. The risk of falls among the aging population: a systematic review and meta-analysis. Front Public Health. 2022;10:902599.PubMedPubMedCentralCrossRef

66.

Moore AA, Whiteman EJ, Ward KT. Risks of combined alcohol/medication use in older adults. Am J Geriatr Pharmacother. 2007;5:64–74.PubMedPubMedCentralCrossRef

67.

Woods AJ, Porges EC, Bryant VE, Seider T, Gongvatana A, Kahler CW, et al. Current heavy alcohol consumption is Associated with Greater Cognitive Impairment in older adults. Alcohol Clin Exp Res. 2016;40:2435–44.PubMedPubMedCentralCrossRef

68.

Gebre BB. Factors Associated with Alcohol Use Disorder among people living with HIV/AIDS attending Art Clinic, Mizan Tep University Teaching Hospital, South West Ethiopia. HIV AIDS (Auckl). 2019;11:239–45.PubMed

69.

Soboka M, Tesfaye M, Feyissa GT, Hanlon C. Alcohol use disorders and associated factors among people living with HIV who are attending services in South West Ethiopia. BMC Res Notes. 2014;7:828.PubMedPubMedCentralCrossRef

70.

Veld DHI, ’t, Pengpid S, Colebunders R, Skaal L, Peltzer K. High-risk alcohol use and associated socio-demographic, health and psychosocial factors in patients with HIV infection in three primary health care clinics in South Africa. Int J STD AIDS. 2017;28:651–9.PubMedCrossRef

71.

Crane HM, McCaul ME, Chander G, Hutton H, Nance RM, Delaney JAC, et al. Prevalence and Factors Associated with Hazardous Alcohol Use among persons living with HIV across the US in the current era of antiretroviral treatment. AIDS Behav. 2017;21:1914–25.PubMedPubMedCentralCrossRef

72.

Matson TE, McGinnis KA, Rubinsky AD, Frost MC, Czarnogorski M, Bryant KJ, et al. Gender and alcohol use: influences on HIV care continuum in a national cohort of patients with HIV. AIDS. 2018;32:2247–53.PubMedCrossRef

73.

Gnatienko N, Calver K, Sullivan M, Forman LS, Heeren T, Blokhina E, et al. Heavy alcohol use among women and men living with HIV in Uganda, Russia, and the United States. J Stud Alcohol Drugs. 2021;82:486–92.PubMedPubMedCentralCrossRef

74.

Grant BF, Chou SP, Saha TD, Pickering RP, Kerridge BT, Ruan WJ, et al. Prevalence of 12-Month Alcohol Use, High-Risk drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001–2002 to 2012–2013: results from the national epidemiologic survey on Alcohol and related conditions. JAMA Psychiatry. 2017;74:911–23.PubMedPubMedCentralCrossRef

75.

Leone AG, Trapani D, Schabath MB, Safer JD, Scout NFN, Lambertini M, et al. Cancer in transgender and gender-diverse persons: a review. JAMA Oncol. 2023;9:556–63.PubMedCrossRef

76.

Hughto JMW, Quinn EK, Dunbar MS, Rose AJ, Shireman TI, Jasuja GK. Prevalence and co-occurrence of Alcohol, Nicotine, and other Substance Use Disorder diagnoses among US Transgender and Cisgender adults. JAMA Netw Open. 2021;4:e2036512.PubMedPubMedCentralCrossRef

77.

Somé NH, Shokoohi M, Shield KD, Wells S, Hamilton HA, Elton-Marshall T, et al. Alcohol and cannabis use during the COVID-19 pandemic among transgender, gender-diverse, and cisgender adults in Canada. BMC Public Health. 2022;22:452.PubMedPubMedCentralCrossRef

78.

Azagba S, Latham K, Shan L. Cigarette, smokeless tobacco, and alcohol use among transgender adults in the United States. Int J Drug Policy. 2019;73:163–9.PubMedCrossRef

79.

Heath K, Samji H, Nosyk B, Colley G, Gilbert M, Hogg RS, et al. Cohort profile: seek and treat for the optimal prevention of HIV/AIDS in British Columbia (STOP HIV/AIDS BC). Int J Epidemiol. 2014;43:1073–81.PubMedPubMedCentralCrossRef

80.

Juwono S, Milloy M-J, Choi J, Fairbairn N, Nolan S, Socías ME. Opioid agonist treatment improves progression through the HIV cascade of care among people living with HIV who use unregulated opioids. AIDS. 2022;36:1429–36.PubMedCrossRef

81.

Reddon H, Fairbairn N, Grant C, Milloy M-J. Experiencing homelessness and progression through the HIV cascade of care among people who use drugs. AIDS. 2023;37:1431–40.PubMedCrossRef

82.

Binswanger IA, Nowels C, Corsi KF, Glanz J, Long J, Booth RE, et al. Return to drug use and overdose after release from prison: a qualitative study of risk and protective factors. Addict Sci Clin Pract. 2012;7:3.PubMedPubMedCentralCrossRef

83.

Pelissier B, Wallace S, O’Neil JA, Gaes GG, Camp S, Rhodes W, et al. Federal prison residential drug treatment reduces substance use and arrests after release. Am J Drug Alcohol Abuse. 2001;27:315–37.PubMedCrossRef

84.

Mulia N, Tam TW, Schmidt LA. Disparities in the use and quality of alcohol treatment services and some proposed solutions to narrow the gap. Psychiatr Serv. 2014;65:626–33.PubMedPubMedCentralCrossRef

85.

Choi NG, DiNitto DM. Alcohol use disorder and treatment receipt among individuals aged 50 years and older: other substance use and psychiatric correlates. J Subst Abuse Treat. 2021;131:108445.PubMedCrossRef

86.

Socias ME, Scheuermeyer FX, Cui Z, Mok WY, Crabtree A, Fairbairn N et al. Using a cascade of care framework to identify gaps in access to medications for alcohol use disorder in British Columbia, Canada. Addiction. 2023.

87.

Bharat C, Webb P, Wilkinson Z, McKetin R, Grebely J, Farrell M et al. Agreement between self-reported illicit drug use and biological samples: a systematic review and meta-analysis. Addiction. 2023.

88.

Rahm-Knigge RL, Norris AL, Dunsiger S. The moderating effects of alcohol use on the association between sexual orientation and HIV testing: results from the 2013–2018 National Health interview study. AIDS Care. 2023;35:1299–305.PubMedCrossRef

89.

Newcomb ME, Hill R, Buehler K, Ryan DT, Whitton SW, Mustanski B. High Burden of Mental Health Problems, Substance Use, Violence, and related psychosocial factors in Transgender, Non-binary, and gender diverse youth and young adults. Arch Sex Behav. 2020;49:645–59.PubMedCrossRef

90.

Sohler NL, Li X, Cunningham CO. Gender disparities in HIV Health Care utilization among the severely disadvantaged: can we determine the reasons? AIDS Patient Care STDS. 2009;23:775–83.PubMedPubMedCentralCrossRef

91.

Mayer KH, Grinsztejn B, El-Sadr WM. Transgender people and HIV Prevention: what we know and what we need to know, a call to action. J Acquir Immune Defic Syndr. 2016;72:S207–9.PubMedPubMedCentralCrossRef

Titel: Prevalence and Correlates of Heavy Alcohol use among People Living with HIV who use Unregulated Drugs in Vancouver, Canada
verfasst von: Jeremy Hui
Hudson Reddon
Nadia Fairbairn
JinCheol Choi
M-J Milloy
Maria Eugenia Socias
Publikationsdatum: 25.04.2024
Verlag: Springer US
Erschienen in: AIDS and Behavior
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-024-04341-y

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen