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首页> 外文期刊>AIDS care. >HAART receipt and viral suppression among HIV-infected patients with co-occurring mental illness and illicit drug use.
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HAART receipt and viral suppression among HIV-infected patients with co-occurring mental illness and illicit drug use.

机译：合并感染的精神疾病和非法药物使用的艾滋病毒感染患者的HAART接受和病毒抑制。

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摘要

Mental illness (MI) and illicit drug use (DU) frequently co-occur. We sought to determine the individual and combined effects of MI and DU on highly active antiretroviral therapy (HAART) receipt and HIV-RNA suppression among individuals engaged in HIV care. Using 2004 data from the HIV Research Network (HIVRN), we performed a cross-sectional study of HIV-infected patients followed at seven primary care sites. Outcomes of interest were HAART receipt and virological suppression, defined as an HIV-RNA <400 copies/ml. Independent variables of interest were: (1) MI/DU; (2) DU only; (3) MI only; and (4) Neither. We used chi-squared analysis for comparison of categorical variables, and logistic regression to adjust for age, race, sex, frequency of outpatient visits, years in clinical care, CD4 nadir, and study site. During 2004, 10,284 individuals in the HIVRN were either on HAART or HAART eligible defined as a CD4 cell count < or =350. Nearly half had neither MI nor DU (41%), 22% MI only, 15% DU only, and 22% both MI and DU. In multivariate analysis, co-occurring MI/DU was associated with the lowest odds of HAART receipt (Adjusted Odds Ratio: 0.63 (95% CI: (0.55-0.72]), followed by those with DU only (0.75(0.63-0.87)), compared to those with neither. Among those on HAART, concurrent MI/DU (0.66 (0.58-0.75)), DU only (0.77 (0.67-0.88)), were also associated with a decreased odds of HIV-RNA suppression compared to those with neither. MI only was not associated with a statistically significant decrease in HAART receipt (0.93(0.81-1.07)) or viral suppression (0.93 (0.82-1.05)) compared to those with neither. Post-estimation testing revealed a significant difference between those with MI/DU and DU only, and MI/DU and MI only. Co-occurring MI and DU is associated with lower HAART receipt and viral suppression compared to individuals with either MI or DU or neither. Integrating HIV, substance abuse, and mental healthcare may improve outcomes in this population.
机译：精神疾病（MI）和非法药物使用（DU）经常并发。我们试图确定在从事HIV护理的个人中，MI和DU对高活性抗逆转录病毒疗法（HAART）接受和HIV-RNA抑制的个体和综合作用。利用来自HIV研究网络（HIVRN）的2004年数据，我们对七个主要护理地点的HIV感染患者进行了横断面研究。感兴趣的结果是接受HAART和病毒学抑制，定义为<400拷贝/ ml的HIV-RNA。感兴趣的独立变量是：（1）MI / DU; （2）仅DU; （3）仅MI; （4）两者都不是。我们使用卡方分析来比较类别变量，并使用逻辑回归来调整年龄，种族，性别，门诊就诊频率，临床护理年限，CD4最低点和研究地点。在2004年期间，HIVRN中有10,284名患者处于HAART或符合HAART的定义为CD4细胞计数≤350。近一半既没有MI也没有DU（41％），仅22％MI，仅15％DU，以及22％MI和DU。在多变量分析中，同时发生的MI / DU与HAART接收的最低几率相关（调整后的赔率：0.63（95％CI：（0.55-0.72]），其次是仅具有DU的那些（0.75（0.63-0.87））相比之下，在没有进行HAART治疗的患者中，并发MI / DU（0.66（0.58-0.75）），仅DU（0.77（0.67-0.88））与HIV-RNA抑制率相比也有所降低相对于两者均没有者，仅MI与HAART接受率（0.93（0.81-1.07））或病毒抑制（0.93（0.82-1.05））的统计学上显着降低没有关联。与只有MI / DU和DU或没有MI / DU和DU的人相比，同时出现MI和DU的人与没有MI或DU或两者都不有的人的HAART接受率和病毒抑制率低相关。 ，精神保健可以改善这一人群的预后。

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