Lytt I Gardner1, Gary Marks2, Steffanie A Strathdee3, Anita M Loughlin4, Carlos Del Rio5, Peter Kerndt6, Pamela Mahoney7, Marc A Pitasi8, Lisa R Metsch9. 1. Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA. Electronic address: lig0@cdc.gov. 2. Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA. Electronic address: gdm8@cdc.gov. 3. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: sstrathdee@ucsd.edu. 4. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: anita.loughlin@optum.com. 5. Department of Global Health, Rollins School of Public Health, and Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: cdelrio@emory.edu. 6. Department of Internal Medicine, Division of Infectious Disease, Los Angeles County and University of Southern California Medical Center, Los Angeles, CA, USA. Electronic address: prk1@cdc.gov. 7. Health Research Association, Los Angeles, CA, USA. Electronic address: pam.mahoney@epiresources.com. 8. Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA. Electronic address: vval@cdc.gov. 9. University of Miami School of Medicine, Miami, FL, USA. Electronic address: lm2892@cumc.columbia.edu.
Abstract
OBJECTIVE: We evaluated whether being in drug use treatment improves linkage to HIV medical care for HIV-infected drug users. We assessed whether an evidence-based intervention for linkage to care ['ARTAS'] works better for HIV-infected drug users who had been in drug use treatment than those who had not. DESIGN: Randomized trial. METHODS:295 Participants in the Antiretroviral Treatment Access Study ['ARTAS'] trial were followed for time to first HIV medical care. Drug use (injected and non-injected drugs) in the last 30days and being in drug treatment in the last 12 months were assessed by audio-CASI. We used a proportional hazards model of time to care in drug users with and without drug treatment, adjusting for barriers to care, AIDS symptoms, and demographic factors. We tested whether drug treatment modified the intervention effect by using a drug use/drug treatment*intervention interaction term. RESULTS:Ninety-nine participants (30%) reported drug use in the 30days before enrollment. Fifty-three (18%) reported being in a drug treatment program in the last 12 months. Drug users reporting methadone maintenance became engaged in care in less than half the time of drug users without a treatment history [HR 2.97 (1.20, 6.21)]. The ARTAS intervention effect was significantly larger for drug users with a treatment history compared to drug users without a treatment history (AHR 5.40, [95% CI, 2.03-14.38]). CONCLUSIONS: Having been in drug treatment programs facilitated earlier entry into care among drug users diagnosed with HIV infection, and improved their response to the ARTAS linkage intervention. Published by Elsevier Ireland Ltd.
RCT Entities:
OBJECTIVE: We evaluated whether being in drug use treatment improves linkage to HIV medical care for HIV-infected drug users. We assessed whether an evidence-based intervention for linkage to care ['ARTAS'] works better for HIV-infected drug users who had been in drug use treatment than those who had not. DESIGN: Randomized trial. METHODS: 295 Participants in the Antiretroviral Treatment Access Study ['ARTAS'] trial were followed for time to first HIV medical care. Drug use (injected and non-injected drugs) in the last 30days and being in drug treatment in the last 12 months were assessed by audio-CASI. We used a proportional hazards model of time to care in drug users with and without drug treatment, adjusting for barriers to care, AIDS symptoms, and demographic factors. We tested whether drug treatment modified the intervention effect by using a drug use/drug treatment*intervention interaction term. RESULTS: Ninety-nine participants (30%) reported drug use in the 30days before enrollment. Fifty-three (18%) reported being in a drug treatment program in the last 12 months. Drug users reporting methadone maintenance became engaged in care in less than half the time of drug users without a treatment history [HR 2.97 (1.20, 6.21)]. The ARTAS intervention effect was significantly larger for drug users with a treatment history compared to drug users without a treatment history (AHR 5.40, [95% CI, 2.03-14.38]). CONCLUSIONS: Having been in drug treatment programs facilitated earlier entry into care among drug users diagnosed with HIV infection, and improved their response to the ARTAS linkage intervention. Published by Elsevier Ireland Ltd.
Entities:
Keywords:
HIV; Linkage to HIV medical care; Randomized trial; Substance use
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