The Association of Mental Health and Substance Use With Retention in HIV Care Among Black Women in Washington, District of Columbia

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Womens Health Issues Pub Date : 2024-05-01 DOI:10.1016/j.whi.2023.11.003
Bianca Stewart MPH , Morgan Byrne MPH , Matthew Levy PhD , Michael A. Horberg MD, MAS, FACP, FIDSA , Anne K. Monroe MD, MSPH , Amanda D. Castel MD, MPH, FAAP, AAHIVS
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Abstract

Background

Black women with HIV are impacted by mental health and substance use disorders alongside barriers to care. The impact of these disorders on retention in care, a crucial step of the HIV care continuum, has not been well-studied. We examined the association between these disorders and retention in care over a 2-year period.

Methods

Data from January 1, 2011, to June 30, 2019, were obtained from the DC Cohort, an observational HIV study in Washington, District of Columbia. We examined the associations between mental health (i.e., mood-related or trauma-related) or substance use disorders, separately, on not being retained in HIV care over a 2-year interval post-enrollment among non-Hispanic Black women with HIV. Multivariate logistic regression with adjusted odds ratios (aORs) for sociodemographic and clinical variables was used to quantify the association of 1) having a confirmed mental health or substance use disorder and 2) not being retained in care.

Results

Among the 2,181 women in this analysis, 690 (31.64%) were not retained in care. The prevalence of a mood-related disorder (39.84%) was higher compared with a substance use (16.19%) or trauma-related disorder (7.75%). Age per a 10-year increase (aOR 0.87; confidence interval [CI] 0.80, 0.94) and a mood-related disorder diagnosis (aOR 0.72; CI: 0.59, 0.88) were inversely associated with not being retained in care.

Conclusion

Mood-related disorders were prevalent among Black women with HIV in Washington, District of Columbia, but were not associated with worse retention in care. Future studies should examine key facilitators for Black women with HIV and coexisting mood-related disorders and how they impact retention in care.

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哥伦比亚特区华盛顿黑人妇女的心理健康和药物使用与继续接受艾滋病护理的关系。
背景:感染艾滋病毒的黑人妇女在受到心理健康和药物使用障碍影响的同时,还面临着护理方面的障碍。这些障碍对继续接受治疗的影响尚未得到充分研究,而继续接受治疗是艾滋病治疗的关键步骤。我们研究了这些障碍与两年内继续接受护理之间的关系:我们从哥伦比亚特区华盛顿的一项艾滋病观察性研究 DC Cohort 中获得了 2011 年 1 月 1 日至 2019 年 6 月 30 日的数据。我们分别研究了感染艾滋病病毒的非西班牙裔黑人女性中,心理健康(即情绪相关或创伤相关)或药物使用障碍与在注册后两年内未继续接受艾滋病护理之间的关联。我们使用调整了社会人口学和临床变量的几率比(aORs)的多变量逻辑回归来量化 1)确诊精神健康或药物使用障碍与 2)未继续接受护理之间的关联:在参与分析的 2 181 名女性中,有 690 人(31.64%)未继续接受护理。与药物使用(16.19%)或创伤相关障碍(7.75%)相比,情绪相关障碍(39.84%)的发病率更高。年龄每增加 10 岁(aOR:0.87;置信区间 [CI]:0.80,0.94)和情绪相关障碍诊断(aOR:0.72;CI:0.59,0.88)与不继续接受护理成反比:结论:在哥伦比亚特区华盛顿,情绪相关障碍在感染艾滋病毒的黑人妇女中很普遍,但与护理保留率下降无关。未来的研究应该研究感染艾滋病毒并同时患有情绪相关障碍的黑人女性的主要促进因素,以及这些因素对继续接受护理的影响。
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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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