Natalie E Chichetto1, Brittanny M Polanka2, Kaku A So-Armah3, Minhee Sung4, Jesse C Stewart2, John R Koethe5,6, E Jennifer Edelman4, Hilary A Tindle5,7, Matthew S Freiberg5,7. 1. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. Natalie.chichetto@vumc.org. 2. Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA. 3. Department of Medicine, Boston University School of Medicine, Boston, MA, USA. 4. Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA. 5. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. 6. Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA. 7. Veterans Affairs Tennessee Valley Healthcare System, Geriatric Research Education and Clinical Centers, Nashville, TN, USA.
Abstract
PURPOSE OF REVIEW: We summarize recent literature on the contribution of substance use and depression to non-AIDS-related comorbidities. Discussion of recent randomized clinical trials and implementation research to curtail risk attributed to each behavioral health issue is provided. RECENT FINDINGS: Smoking, unhealthy alcohol use, opioid use, and depression are common among PWH and individually contribute to increased risk for non-AIDS-related comorbidities. The concurrence of these conditions is notable, yet understudied, and provides opportunity for linked-screening and potential treatment of more than one behavioral health factor. Current results from randomized clinical trials are inconsistent. Investigating interventions to reduce the impact of these behavioral health conditions with a focus on implementation into clinical care is important. Non-AIDS-defining cancers, cardiovascular disease, liver disease, and diabetes are leading causes of morbidity in people with HIV. Behavioral health factors including substance use and mental health issues, often co-occurring, likely contribute to the excess risk of non-AIDS-related comorbidities.
PURPOSE OF REVIEW: We summarize recent literature on the contribution of substance use and depression to non-AIDS-related comorbidities. Discussion of recent randomized clinical trials and implementation research to curtail risk attributed to each behavioral health issue is provided. RECENT FINDINGS: Smoking, unhealthy alcohol use, opioid use, and depression are common among PWH and individually contribute to increased risk for non-AIDS-related comorbidities. The concurrence of these conditions is notable, yet understudied, and provides opportunity for linked-screening and potential treatment of more than one behavioral health factor. Current results from randomized clinical trials are inconsistent. Investigating interventions to reduce the impact of these behavioral health conditions with a focus on implementation into clinical care is important. Non-AIDS-defining cancers, cardiovascular disease, liver disease, and diabetes are leading causes of morbidity in people with HIV. Behavioral health factors including substance use and mental health issues, often co-occurring, likely contribute to the excess risk of non-AIDS-related comorbidities.
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