Associations between drug and alcohol use, smoking, and frailty among people with HIV across the United States in the current era of antiretroviral treatment

被引:7
|
作者
Crane, Heidi M. [1 ]
Ruderman, Stephanie A. [1 ]
Whitney, Bridget M. [1 ]
Nance, Robin M. [1 ]
Drumright, Lydia N. [2 ]
Webel, Allison R. [3 ]
Willig, Amanda L. [4 ]
Saag, Michael S. [4 ]
Christopoulos, Katerina [5 ]
Greene, Meredith [6 ]
Hahn, Andrew W. [1 ]
Eron, Joseph J. [7 ]
Napravnik, Sonia [8 ]
Mathews, William Christopher [9 ]
Chander, Geetanjali [10 ]
McCaul, Mary E. [11 ]
Cachay, Edward R. [9 ]
Mayer, Kenneth H. [12 ]
Landay, Alan [13 ]
Austad, Steven [14 ]
Ma, Jimmy [1 ]
Kritchevsky, Stephen B. [15 ]
Pandya, Chintan [16 ]
Achenbach, Chad [17 ]
Cartujano-Barrera, Francisco [18 ]
Kitahata, Mari [1 ]
Delaney, Joseph A. C. [19 ]
Kamen, Charles [20 ]
机构
[1] Harborview Med Ctr, Dept Med, 325 9th Ave,Box 359931, Seattle, WA 98104 USA
[2] Harborview Med Ctr, Dept Biobehav Nursing & Hlth Informat, 325 9th Ave,Box 359931, Seattle, WA 98104 USA
[3] Univ Washington, Dept Child Family & Populat Hlth Nursing, Hlth Sci Bldg,Box 357260,1959 NE Pacific Ave, Seattle, WA 98195 USA
[4] Univ Alabama Birmingham, Div Infect Dis, Dept Med, 1720 2nd Ave South, Birmingham, AL 35294 USA
[5] Univ Calif San Francisco, Sch Med, 1001 Potrero Ave, San Francisco, CA 94110 USA
[6] Univ Calif San Francisco, Sch Med, 490 Illinois St, San Francisco, CA 94158 USA
[7] Univ N Carolina, CB 7030,Bioinformat Bldg,130 Mason Farm Rd, Chapel Hill, NC 27599 USA
[8] Dept Epidemiol, 130 Mason Farm Rd,2101 Bioinformat Bldg, Chapel Hill, NC 27599 USA
[9] Univ Calif San Diego, UC San Diego Hlth Syst, Owen Clin, San Diego, CA 92103 USA
[10] Carnegie, Dept Med, 600N Wolfe St, Baltimore, MD 21287 USA
[11] Johns Hopkins Univ, Dept Psychiat & Behav Sci, Sch Med, 3400N Charles St, Baltimore, MD 21218 USA
[12] Fenway Hlth, Fenway Inst, 1340 Boylston St, Boston, MA 02215 USA
[13] Rush Univ, 1735 W Harrison St, Chicago, IL 60612 USA
[14] Univ Alabama Birmingham, Dept Biol, Campbell Hall,1300 Univ Blvd, Birmingham, AL USA
[15] Wake Forest Sch Med, Stricht Ctr Hlth Aging & Alzheimers Prevent, Dept Internal Med Gerontol & Geriatr Med, 475 Vine St, Winston Salem, NC 27101 USA
[16] Johns Hopkins Univ, Ctr Populat Hlth Informat Technol, Wolfe St, Baltimore, MD 21205 USA
[17] Northwestern Univ, Dept Med, Feinberg Sch Med, 645 N Michigan Ave 1, Chicago, IL 60611 USA
[18] Univ Rochester, Med Ctr, Dept Publ Hlth Sci, Rochester, NY 14642 USA
[19] Univ Manitoba, Rady Fac Hlth Sci, Coll Pharm, Winnipeg, MB, Canada
[20] Univ Rochester, Med Ctr, Dept Surg, Rochester, NY 14642 USA
关键词
Substance use; Frailty; Alcohol use; Methamphetamine use; HIV; Cigarette smoking; HUMAN-IMMUNODEFICIENCY-VIRUS; SCREENING-TEST ASSIST; QUALITY-OF-LIFE; PHYSICAL-ACTIVITY; OLDER-ADULTS; CONSUMPTION QUESTIONS; TREATMENT OUTCOMES; RISK-FACTORS; PHENOTYPE; HEALTH;
D O I
10.1016/j.drugalcdep.2022.109649
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Objective: To examine associations between frailty and drug, alcohol, and tobacco use among a large diverse cohort of people with HIV (PWH) in clinical care in the current era.Methods: PWH at 7 sites across the United States completed clinical assessments of patient-reported measures and outcomes between 2016 and 2019 as part of routine care including drug and alcohol use, smoking, and other domains. Frailty was assessed using 4 of the 5 components of the Fried frailty phenotype and PWH were cate-gorized as not frail, pre-frail, or frail. Associations of substance use with frailty were assessed with multivariate Poisson regression.Results: Among 9336 PWH, 43% were not frail, 44% were prefrail, and 13% were frail. Frailty was more prev-alent among women, older PWH, and those reporting current use of drugs or cigarettes. Current methamphet-amine use (1.26: 95% CI 1.07-1.48), current (1.65: 95% CI 1.39-1.97) and former (1.21:95% CI 1.06-1.36) illicit opioid use, and former cocaine/crack use (1.17: 95% CI 1.01-1.35) were associated with greater risk of being frail in adjusted analyses. Current smoking was associated with a 61% higher risk of being frail vs. not frail (1.61: 95% CI 1.41-1.85) in adjusted analyses.Conclusions: We found a high prevalence of prefrailty and frailty among a nationally distributed cohort of PWH in care. This study identified distinct risk factors that may be associated with frailty among PWH, many of which, such as cigarette smoking and drug use, are potentially modifiable.
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页数:9
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