TY - JOUR
T1 - African American/Black and Latino Adults with Detectable HIV Viral Load Evidence Substantial Risk for Polysubstance Substance Use and Co-occurring Problems
T2 - A Latent Class Analysis
AU - Cleland, Charles M.
AU - Gwadz, Marya
AU - Collins, Linda M.
AU - Wilton, Leo
AU - Sherpa, Dawa
AU - Dorsen, Caroline
AU - Leonard, Noelle R.
AU - Cluesman, Sabrina R.
AU - Martinez, Belkis Y.
AU - Ritchie, Amanda S.
AU - Ayvazyan, Mariam
N1 - Funding Information:
The study was sponsored by the National Institute on Drug Abuse [(NIDA), R01DA040480; Drs. Marya Gwadz and Linda M. Collins, MPI; and P30DA011041, Center for Drug Use and HIV Research (CDUHR), Dr. Holly Hagan, Principal Investigator] at the National Institutes of Health. We gratefully acknowledge our Program Official at NIDA, Dr. Richard Jenkins, for guidance throughout the study, as well as Dr. Shoshana Kahana at NIDA, and Bruss Del Valle and Pauline Lee in the Office for Research at the NYU Silver School of Social Work. We wish to acknowledge Dr. Gail Melkus, Mindy Belkin, William McCormack, and Mary Lou Atkinson at the NYU Meyers College of Nursing for their support of the project. Amanda Applegate provided editorial assistance. The HTH2 Collaborative Research Team members, past and present, include J. Yvette Allen, Mariam Ayvazyan, Nico Bobb, Dr. Scott Braithwaite, Adonis Brooks, Dr. Charles M. Cleland, Sabrina Cluesman, Camille Collett, Dr. Caroline Dorsen, Dan Ediriweera, Brooks Fassett, Krystel Francis, Robert M. Freeman, Gail Gonzales, Ning He, Elona Hoffeld, Theresa Hroncich, Eshika Kalam, Sarah Kaufman, Daniel Kelly, Donna Kennedy, Alexis Korman, Dr. Alix Kutnick, Dr. Noelle Leonard, Maria Levine, Belkis Martinez, Sarah Ory, Shantae Owens, Anisha Pal, Emily Pan, Danny Quinones, Amanda Ritchie, Dawa Sherpa, Elizabeth Silverman, Stephen Sorgi, Aradhana Srinagesh, Karen Torbjornsen, Catherine Tumminello, Dr. Leo Wilton, and Andrea Wade. Most importantly, we gratefully acknowledge the study participants for their vital contributions to the study.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/8
Y1 - 2021/8
N2 - Substance use problems are highly prevalent among persons living with (PLWH) in the United States and serve as serious barriers to engagement in HIV care. Yet, in contrast to studies of single substances, little is known about patterns of polysubstance use in this population. Moreover, other risk factors (e.g., financial hardship, incarceration, homelessness, and mental health distress) are also prevalent and complicate HIV management. The present study drew on a cross-sectional survey with African American/Black and Latino (AABL) adult PLWH from low socioeconomic status backgrounds in New York City who were insufficiently engaged in HIV care and evidenced detectable HIV viral load (N = 512). We used latent class analysis (LCA) to explore patterns of polysubstance use and their relationships to financial hardship, incarceration, homelessness, and mental health. LCA yielded three substance use classes: Class 1, a high polysubstance use/high-risk substance use class (9%); Class 2, a polysubstance use/moderate substance use risk class (18%); and Class 3, a moderate polysubstance use/moderate-to-low-risk substance use class (74%). Mental health symptoms were prevalent in all classes, but Class 1 had greater mental health distress than the other two classes. Current homelessness was more prevalent in Classes 1 and 2. We cannot end the HIV epidemic without engaging and treating AABL PLWH who have serious barriers to engagement along the HIV care continuum, and who evidence polysubstance use along with co-occurring risk factors. Clinical settings can develop outreach and engagement approaches to bring this subpopulation of PLWH into care settings, and further, specialized services are needed to successfully screen, treat, and retain them.
AB - Substance use problems are highly prevalent among persons living with (PLWH) in the United States and serve as serious barriers to engagement in HIV care. Yet, in contrast to studies of single substances, little is known about patterns of polysubstance use in this population. Moreover, other risk factors (e.g., financial hardship, incarceration, homelessness, and mental health distress) are also prevalent and complicate HIV management. The present study drew on a cross-sectional survey with African American/Black and Latino (AABL) adult PLWH from low socioeconomic status backgrounds in New York City who were insufficiently engaged in HIV care and evidenced detectable HIV viral load (N = 512). We used latent class analysis (LCA) to explore patterns of polysubstance use and their relationships to financial hardship, incarceration, homelessness, and mental health. LCA yielded three substance use classes: Class 1, a high polysubstance use/high-risk substance use class (9%); Class 2, a polysubstance use/moderate substance use risk class (18%); and Class 3, a moderate polysubstance use/moderate-to-low-risk substance use class (74%). Mental health symptoms were prevalent in all classes, but Class 1 had greater mental health distress than the other two classes. Current homelessness was more prevalent in Classes 1 and 2. We cannot end the HIV epidemic without engaging and treating AABL PLWH who have serious barriers to engagement along the HIV care continuum, and who evidence polysubstance use along with co-occurring risk factors. Clinical settings can develop outreach and engagement approaches to bring this subpopulation of PLWH into care settings, and further, specialized services are needed to successfully screen, treat, and retain them.
UR - http://www.scopus.com/inward/record.url?scp=85102307622&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85102307622&partnerID=8YFLogxK
U2 - 10.1007/s10461-021-03212-0
DO - 10.1007/s10461-021-03212-0
M3 - Article
C2 - 33683531
AN - SCOPUS:85102307622
SN - 1090-7165
VL - 25
SP - 2501
EP - 2516
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 8
ER -