Substance Use Treatment Utilization Among Women With and Without Human Immunodeficiency Virus

Ayako W Fujita; Aditi Ramakrishnan; C Christina Mehta; Oyindamola B Yusuf; Tracey Wilson; Steven Shoptaw; Adam W Carrico; Adaora A Adimora; Ellen Eaton; Mardge H Cohen; Jennifer Cohen; Adebola Adedimeji; Michael Plankey; Deborah Jones; Aruna Chandran; Jonathan A Colasanti; Anandi N Sheth

doi:10.1093/ofid/ofac684

Substance Use Treatment Utilization Among Women With and Without Human Immunodeficiency Virus

Open Forum Infect Dis. 2022 Dec 21;10(1):ofac684. doi: 10.1093/ofid/ofac684. eCollection 2023 Jan.

Authors

Ayako W Fujita¹, Aditi Ramakrishnan^{1

2}, C Christina Mehta¹, Oyindamola B Yusuf¹, Tracey Wilson³, Steven Shoptaw⁴, Adam W Carrico⁵, Adaora A Adimora⁶, Ellen Eaton⁷, Mardge H Cohen⁸, Jennifer Cohen⁹, Adebola Adedimeji¹⁰, Michael Plankey¹¹, Deborah Jones¹², Aruna Chandran¹³, Jonathan A Colasanti^{1

14}, Anandi N Sheth¹

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
² Division of Infectious Diseases, School of Medicine, Washington University in St Louis, St Louis, Missouri, USA.
³ Department of Community Health Sciences, School of Public Health, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA.
⁴ Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
⁵ Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
⁶ Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁷ Division of Infectious Diseases, Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama, USA.
⁸ Department of Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA.
⁹ Department of Medicine, Infectious Diseases, University of California, San Francisco, San Francisco, California, USA.
¹⁰ Division of Health Behavior Research and Implementation Science, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
¹¹ Division of General Internal Medicine, Department of Medicine, Georgetown University Medical Center, Washington, District of Columbia, USA.
¹² Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
¹³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
¹⁴ Infectious Disease Program, Grady Health System, Atlanta, Georgia, USA.

Abstract

Background: Substance use (SU) contributes to poor health outcomes, yet limited data exist to inform strategies to optimize SU treatment among persons with human immunodeficiency virus (HIV). We describe SU and SU treatment utilization among women with and without HIV in the Women's Interagency HIV Study (WIHS).

Methods: We included data from women enrolled in WIHS from 2013 to 2020. Current SU was self-reported, nonmedical use of drugs in the past year, excluding use of only marijuana. SU treatment utilization was self-reported use of a drug treatment program in the past year. Multivariable regression models were used to investigate associations between participant characteristics and SU treatment.

Results: Among 2559 women (1802 women living with HIV [WWH], 757 women without HIV), 14% reported current SU. Among those with current SU (n = 367), 71% reported crack/cocaine followed by 40% reporting opioids, and 42% reported any treatment in the past year. The most common treatments were methadone (64%), Narcotics Anonymous (29%), inpatient programs (28%), and outpatient programs (16%). Among women using opioids (n = 147), 67% reported methadone use in the past year compared to 5% using buprenorphine/naloxone. Multivariable analysis showed lower odds of treatment utilization among WWH with concurrent alcohol or marijuana use. Visiting a psychiatrist/counselor was associated with higher odds of treatment. Among WWH, SU treatment was not associated with HIV-related clinical outcomes.

Conclusions: Treatment utilization was high, especially for methadone use. Our results highlight opportunities for accessing SU treatment for WWH, such as the need to prioritize buprenorphine and comprehensive, wraparound services in HIV care settings.

Keywords: HIV; addiction; substance use; women.

Abstract

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