Derek D Satre1, Tory Levine-Hall2, Stacy A Sterling2, Kelly C Young-Wolff3, Jennifer O Lam2, Stacey Alexeeff2, J Carlo Hojilla2, Andrew Williams4, Amy C Justice5, Jonathan Sterne6, Matthias Cavassini7, Kendall J Bryant8, Emily C Williams9, Michael A Horberg10, Paul Volberding11, Constance Weisner3, Michael J Silverberg2. 1. Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Kaiser Permanente Northern California, Oakland, CA, USA. Electronic address: derek.satre@ucsf.edu. 2. Kaiser Permanente Northern California, Oakland, CA, USA. 3. Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Kaiser Permanente Northern California, Oakland, CA, USA. 4. Tufts Medical Center, Boston, MA, USA. 5. Yale University, New Haven, CT, USA. 6. University of Bristol, Bristol, UK. 7. Lausanne University Hospital, Lausanne, Switzerland. 8. National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA. 9. Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered Value-Driven Care, Veteran Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA; Department of Health Services, University of Washington, Seattle, WA, USA. 10. Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA. 11. AIDS Research Institute, University of California, San Francisco, USA.
Abstract
INTRODUCTION: Smoking tobacco and unhealthy alcohol use may negatively influence HIV care continuum outcomes but have not been examined in combination. METHODS: Participants were people with HIV (PWH) in Kaiser Permanente Northern California. Predictors included smoking status and unhealthy alcohol use (exceeding daily and/or weekly limits) reported by patients during primary care screening (index date). Outcomes were based on not achieving the following steps in the care continuum: linkage to HIV care (≥1 visit within 90 days of newly identified HIV diagnosis), retention (2+ in-person visits, 60+ days apart) and HIV RNA control (<75 copies/mL). Adjusted odds ratios (ORs) were obtained from separate logistic regression models for each outcome associated with smoking and unhealthy alcohol use independently and combined. RESULTS: The overall sample (N = 8958) had a mean age of 48.0 years; was 91.3 % male; 54.0 % white, 17.6 % Latino, 15.1 % black, and 9.6 % other race/ethnicity. Smoking was associated with higher odds of not being linked to HIV care (OR = 1.60 [95 % CI 1.03-2.48]), not retained (OR = 1.30 [95 % CI 1.13-1.50]), and HIV RNA not in control (OR = 1.91 [95 % CI 1.60-2.27]). Alcohol measures were not independently associated with outcomes. The combination of unhealthy alcohol use and smoking (versus neither) was associated with higher odds of not being linked to care (OR = 2.83 [95 % CI 1.40-5.71]), although the interaction did not reach significance (p = 0.18). CONCLUSIONS: In this large sample of PWH in an integrated health care system, smoking, both independently and in combination with unhealthy alcohol use, was associated with worse HIV care continuum outcomes.
INTRODUCTION: Smoking tobacco and unhealthy alcohol use may negatively influence HIV care continuum outcomes but have not been examined in combination. METHODS: Participants were people with HIV (PWH) in Kaiser Permanente Northern California. Predictors included smoking status and unhealthy alcohol use (exceeding daily and/or weekly limits) reported by patients during primary care screening (index date). Outcomes were based on not achieving the following steps in the care continuum: linkage to HIV care (≥1 visit within 90 days of newly identified HIV diagnosis), retention (2+ in-person visits, 60+ days apart) and HIV RNA control (<75 copies/mL). Adjusted odds ratios (ORs) were obtained from separate logistic regression models for each outcome associated with smoking and unhealthy alcohol use independently and combined. RESULTS: The overall sample (N = 8958) had a mean age of 48.0 years; was 91.3 % male; 54.0 % white, 17.6 % Latino, 15.1 % black, and 9.6 % other race/ethnicity. Smoking was associated with higher odds of not being linked to HIV care (OR = 1.60 [95 % CI 1.03-2.48]), not retained (OR = 1.30 [95 % CI 1.13-1.50]), and HIV RNA not in control (OR = 1.91 [95 % CI 1.60-2.27]). Alcohol measures were not independently associated with outcomes. The combination of unhealthy alcohol use and smoking (versus neither) was associated with higher odds of not being linked to care (OR = 2.83 [95 % CI 1.40-5.71]), although the interaction did not reach significance (p = 0.18). CONCLUSIONS: In this large sample of PWH in an integrated health care system, smoking, both independently and in combination with unhealthy alcohol use, was associated with worse HIV care continuum outcomes.
Authors: Jennifer O Lam; Tory Levine-Hall; Nicole Hood; Stacey E Alexeeff; Michael A Horberg; Kelly C Young-Wolff; Stacy A Sterling; Andrew Williams; Constance Weisner; Derek D Satre; Michael J Silverberg Journal: Drug Alcohol Depend Date: 2020-06-18 Impact factor: 4.852
Authors: Helen C Steel; W D Francois Venter; Annette J Theron; Ronald Anderson; Charles Feldman; Luyanda Kwofie; Tanita Cronjé; Natasha Arullapan; Theresa M Rossouw Journal: Mediators Inflamm Date: 2018-12-09 Impact factor: 4.711
Authors: Giuseppe Vittorio De Socio; Marta Pasqualini; Elena Ricci; Paolo Maggi; Giancarlo Orofino; Nicola Squillace; Barbara Menzaghi; Giordano Madeddu; Lucia Taramasso; Daniela Francisci; Paolo Bonfanti; Francesca Vichi; Marco dell'Omo; Luca Pieroni Journal: BMC Public Health Date: 2020-05-20 Impact factor: 3.295
Authors: Derek D Satre; Sujaya Parthasarathy; Michael J Silverberg; Michael Horberg; Kelly C Young-Wolff; Emily C Williams; Paul Volberding; Cynthia I Campbell Journal: BMC Health Serv Res Date: 2020-11-11 Impact factor: 2.655
Authors: Sally B Coburn; Jodie Dionne-Odom; Maria L Alcaide; Caitlin A Moran; Lisa Rahangdale; Elizabeth T Golub; Leslie Stewart Massad; Dominika Seidman; Katherine G Michel; Howard Minkoff; Kerry Murphy; Todd T Brown; Kala Visvanathan; Bryan Lau; Keri N Althoff Journal: J Womens Health (Larchmt) Date: 2022-01-17 Impact factor: 2.681