Joseph Cox1, Emilie Maurais2, Lina Hu3, Erica E M Moodie3, Stephanie Law3, Nikki Bozinoff4, Martin Potter5, Kathleen Rollet4, Mark Hull6, Mark Tyndall7, Curtis Cooper7, John Gill8, Sahar Saeed4, Marina B Klein9. 1. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2; Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4; Public Health Department, Montreal Health and Social Services Agency, 1301 Sherbrooke Street East, Montreal, Quebec, Canada H2L 1M3; CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6. Electronic address: joseph.cox@mcgill.ca. 2. Public Health Department, Montreal Health and Social Services Agency, 1301 Sherbrooke Street East, Montreal, Quebec, Canada H2L 1M3. 3. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2. 4. Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4. 5. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2; Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4. 6. CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6; BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, British Columbia, Canada V6Z 1Y6. 7. CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6; Department of Medicine, Infectious Diseases Division, University of Ottawa, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6. 8. CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6; Southern Alberta HIV Clinic, 1213 4 Street SW, Calgary, Alberta, Canada T2R 0X7. 9. Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, Quebec, Canada H2X 2P4; CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, British Columbia, Canada V6B 3E6.
Abstract
BACKGROUND: Ongoing drug use remains a barrier to HIV and HCV treatment. We examined the occurrence and correlates of drug use cessation among HIV-HCV co-infected drug users participating in HIV care. METHODS: Participants from the Canadian Co-infection Cohort reporting drug use (injecting drugs and/or smoking crack) with at least two follow-up visits were included (n=521 (43%), 1832 visits). Socio-demographics, behavioural, and health information were collected at each six-month visit. Associations with cessation (no drug use since last visit) were examined using non-linear mixed effects logistic regression models with random intercepts. RESULTS: During follow-up, 361 (69%) participants ceased using drugs. Having a fixed address (aOR [adjusted odds ratio] 1.73, CI [95% confidence interval] 1.02-2.96) and smoking crack without injecting drugs (aOR 3.10, CI 2.05-4.71) were positively associated. Living alone (aOR 0.47, CI 0.35-0.63), current tobacco use (aOR 0.41, CI 0.26-0.64), hazardous alcohol drinking (aOR 0.67, CI 0.49-0.91), snorting drugs (aOR 0.52, CI 0.37-0.74), having a greater exposure to addiction programmes (aOR 0.88, CI 0.81-0.94), having been recruited in Quebec or Nova Scotia (aOR 0.41, CI 0.25-0.66), and British Columbia or Alberta (aOR 0.51, CI 0.32-0.82) were negatively associated. Various socio-demographic (age, education) and health-related (HIV duration, care adherence) factors were not associated. CONCLUSION: Drug use cessation among HIV-HCV co-infected persons is relatively common in this cohort. Stable housing and supportive living situations seem to be important facilitators for drug use cessation in this population. Greater efforts should be made to retain patients in addiction treatment programmes.
BACKGROUND: Ongoing drug use remains a barrier to HIV and HCV treatment. We examined the occurrence and correlates of drug use cessation among HIV-HCV co-infected drug users participating in HIV care. METHODS:Participants from the Canadian Co-infection Cohort reporting drug use (injecting drugs and/or smoking crack) with at least two follow-up visits were included (n=521 (43%), 1832 visits). Socio-demographics, behavioural, and health information were collected at each six-month visit. Associations with cessation (no drug use since last visit) were examined using non-linear mixed effects logistic regression models with random intercepts. RESULTS: During follow-up, 361 (69%) participants ceased using drugs. Having a fixed address (aOR [adjusted odds ratio] 1.73, CI [95% confidence interval] 1.02-2.96) and smoking crack without injecting drugs (aOR 3.10, CI 2.05-4.71) were positively associated. Living alone (aOR 0.47, CI 0.35-0.63), current tobacco use (aOR 0.41, CI 0.26-0.64), hazardous alcohol drinking (aOR 0.67, CI 0.49-0.91), snorting drugs (aOR 0.52, CI 0.37-0.74), having a greater exposure to addiction programmes (aOR 0.88, CI 0.81-0.94), having been recruited in Quebec or Nova Scotia (aOR 0.41, CI 0.25-0.66), and British Columbia or Alberta (aOR 0.51, CI 0.32-0.82) were negatively associated. Various socio-demographic (age, education) and health-related (HIV duration, care adherence) factors were not associated. CONCLUSION: Drug use cessation among HIV-HCV co-infectedpersons is relatively common in this cohort. Stable housing and supportive living situations seem to be important facilitators for drug use cessation in this population. Greater efforts should be made to retain patients in addiction treatment programmes.
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