Jennifer A Fulcher1, Marjan Javanbakht2, Chelsea L Shover2, Amy Ragsdale2, Ron Brookmeyer3, Steven Shoptaw4, Pamina M Gorbach5. 1. Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA; VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA, 90095, USA. Electronic address: jfulcher@mednet.ucla.edu. 2. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA. 3. Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA. 4. Department of Family Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA. 5. Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
Abstract
BACKGROUND: Substance use decreases the likelihood of achieving undetectable HIV viremia; however, the comparative effects by drug have not been fully described. In this study, we compare the effects of methamphetamine use versus other drugs on viremia in sexual minority men on antiretroviral therapy (ART). METHODS: HIV-positive participants currently on ART (N = 230) were selected from an ongoing cohort of diverse young sexual minority men (mSTUDY) enrolled from August 2014 to May 2018. Substance use and sociodemographic factors associated with viremia outcomes were assessed using ordinal regression analysis with generalized estimating equations. Viremia outcomes were grouped as undetectable (<20 copies/mL), low level suppressed (21-200 copies/mL), or not suppressed (>200 copies/mL). RESULTS: The prevalence of drug use across 825 study visits was 73 %, with methamphetamine use most prevalent (50 %). After adjusting for unstable housing and ART adherence, methamphetamine use, either alone (adjusted OR = 1.87; 95 % CI 1.03-3.40) or with other drugs (adjusted OR = 1.82; 95 % CI 1.12-2.95), was associated with higher odds of increasing viremia compared to no drug use. Other drug use excluding methamphetamine did not show a similar association (adjusted OR = 1.29; 95 % CI 0.80-2.09). Among our study population, nearly half the instances of viremia could be reduced if methamphetamine was discontinued (attributable fraction = 46 %; 95 % CI 3-71 %). CONCLUSIONS: Methamphetamine use, either alone or in combination with other drugs, is associated with failure of viral suppression among sexual minority men on ART independent of adherence and sociodemographic factors. This accounts for nearly half of the observed instances of unsuppressed viremia in this study.
BACKGROUND: Substance use decreases the likelihood of achieving undetectable HIV viremia; however, the comparative effects by drug have not been fully described. In this study, we compare the effects of methamphetamine use versus other drugs on viremia in sexual minority men on antiretroviral therapy (ART). METHODS: HIV-positive participants currently on ART (N = 230) were selected from an ongoing cohort of diverse young sexual minority men (mSTUDY) enrolled from August 2014 to May 2018. Substance use and sociodemographic factors associated with viremia outcomes were assessed using ordinal regression analysis with generalized estimating equations. Viremia outcomes were grouped as undetectable (<20 copies/mL), low level suppressed (21-200 copies/mL), or not suppressed (>200 copies/mL). RESULTS: The prevalence of drug use across 825 study visits was 73 %, with methamphetamine use most prevalent (50 %). After adjusting for unstable housing and ART adherence, methamphetamine use, either alone (adjusted OR = 1.87; 95 % CI 1.03-3.40) or with other drugs (adjusted OR = 1.82; 95 % CI 1.12-2.95), was associated with higher odds of increasing viremia compared to no drug use. Other drug use excluding methamphetamine did not show a similar association (adjusted OR = 1.29; 95 % CI 0.80-2.09). Among our study population, nearly half the instances of viremia could be reduced if methamphetamine was discontinued (attributable fraction = 46 %; 95 % CI 3-71 %). CONCLUSIONS: Methamphetamine use, either alone or in combination with other drugs, is associated with failure of viral suppression among sexual minority men on ART independent of adherence and sociodemographic factors. This accounts for nearly half of the observed instances of unsuppressed viremia in this study.
Authors: Adam W Carrico; Annesa Flentje; Kord Kober; Sulggi Lee; Peter Hunt; Elise D Riley; Steven Shoptaw; Elena Flowers; Samantha E Dilworth; Savita Pahwa; Bradley E Aouizerat Journal: Brain Behav Immun Date: 2018-04-18 Impact factor: 7.217
Authors: Adam W Carrico; Peter W Hunt; Torsten B Neilands; Samantha E Dilworth; Jeffrey N Martin; Steven G Deeks; Elise D Riley Journal: J Acquir Immune Defic Syndr Date: 2019-01-01 Impact factor: 3.731
Authors: Matthew J Mimiaga; Sari L Reisner; Chris Grasso; Heidi M Crane; Steven A Safren; Mari M Kitahata; Joseph E Schumacher; W Christopher Mathews; Kenneth H Mayer Journal: Am J Public Health Date: 2013-06-13 Impact factor: 9.308
Authors: Joëlla W Adams; Kendall J Bryant; E Jennifer Edelman; David A Fiellin; Julie R Gaither; Adam J Gordon; Kirsha S Gordon; Kevin L Kraemer; Matthew J Mimiaga; Don Operario; Janet P Tate; Jacob J van den Berg; Amy C Justice; Brandon D L Marshall Journal: AIDS Behav Date: 2018-04
Authors: Harry Jin; Adedotun Ogunbajo; Matthew J Mimiaga; Dustin T Duncan; Edward Boyer; Peter Chai; Samantha E Dilworth; Adam W Carrico Journal: Drug Alcohol Depend Date: 2018-09-13 Impact factor: 4.492
Authors: Niamh Higgins; Barry S Zingman; Judianne Slish; Richard C Reichman; Margaret A Fischl; Barbara Gripshover; Kelly Tooley; Naomi Boston; Alan Forrest; Dan Brazeau; Linda M Catanzaro; Robin DiFrancesco; Francesco Lliguicota; Qing Ma; Gene D Morse Journal: Am J Addict Date: 2007 Nov-Dec
Authors: Michael J Li; Erica Su; Wendy H Garland; Sona Oksuzyan; Sung-Jae Lee; Uyen H Kao; Robert E Weiss; Steven J Shoptaw Journal: J Acquir Immune Defic Syndr Date: 2020-08-01 Impact factor: 3.771
Authors: Marta Massanella; Sara Gianella; Rachel Schrier; Jennifer M Dan; Josué Pérez-Santiago; Michelli F Oliveira; Douglas D Richman; Susan J Little; Constance A Benson; Eric S Daar; Michael P Dube; Richard H Haubrich; Davey M Smith; Sheldon R Morris Journal: Sci Rep Date: 2015-08-24 Impact factor: 4.379
Authors: Steven Meanley; Seul Ki Choi; Azure B Thompson; Jacquelyn L Meyers; Gypsyamber D'Souza; Adaora A Adimora; Matthew J Mimiaga; Mirjam-Colette Kempf; Deborah Konkle-Parker; Mardge H Cohen; Linda A Teplin; Lynn Murchison; Leah H Rubin; Anna A Rubtsova; Deborah Jones Weiss; Brad Aouizerat; Mackey R Friedman; Michael W Plankey; Tracey E Wilson Journal: Drug Alcohol Depend Date: 2021-12-25 Impact factor: 4.492