Jennifer P Jain, Megan J Heise, Nadra E Lisha, Carlos H Moreira, David V Glidden, Greer A Burkholder, Heidi M Crane, Jeffrey M Jacobson, Edward R Cachay, Kenneth H Mayer, Sonia Napravnik, Richard D Moore, Carol Dawson-Rose, Mallory O Johnson, Katerina A Christopoulos, Monica Gandhi, Matthew A Spinelli
{"title":"COVID-19 大流行对美国接受艾滋病毒护理的艾滋病毒感染者药物使用失调风险的影响:中断时间序列分析","authors":"Jennifer P Jain, Megan J Heise, Nadra E Lisha, Carlos H Moreira, David V Glidden, Greer A Burkholder, Heidi M Crane, Jeffrey M Jacobson, Edward R Cachay, Kenneth H Mayer, Sonia Napravnik, Richard D Moore, Carol Dawson-Rose, Mallory O Johnson, Katerina A Christopoulos, Monica Gandhi, Matthew A Spinelli","doi":"10.1093/ofid/ofae491","DOIUrl":null,"url":null,"abstract":"With rising overdose deaths globally and the social isolation of the COVID-19 pandemic, people with HIV (PWH) with substance use disorders (SUD) may have been disproportionately impacted. We examined whether there was a change in SUD risk among PWH before and after the COVID-19 shelter-in-place (SIP) mandate. Data were collected between 2018-2022 among PWH enrolled across 8 U.S. sites in the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) cohort. We evaluated changes in reported moderate/high SUD risk after SIP using interrupted time series analyses fit with a mixed-effects logistic regression model. There were 7,126 participants, including 21,741 SUD assessments. The median age was 51 (IQR=39-58); 12% identified as Hispanic or Latino/a; 46% identified as Black/African American, and 46% White. Moderate/high SUD risk increased continuously after the pandemic’s onset, with 43% (95%CI=40-46%) endorsing moderate/high SUD risk post-SIP, compared to 24% (95%CI=22-26%) pre-SIP (p<.001). There were statistically significant increases in the use of heroin, methamphetamine, and fentanyl, and decreases in prescription opioids and sedatives post-SIP. Further, there was a significant decrease in reported substance use treatment post-SIP compared to pre-SIP, (p=.025). The rising prevalence of SUD through late 2022 could be related to an increase in isolation, depression, and reduced access to substance use and HIV treatment caused by disruptions due to the pandemic. A renewed investment in integrated substance use treatment is vital to address the combined epidemics of substance use and HIV following the COVID pandemic and to support resilience in the face of future disruptions.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Impact of the COVID-19 Pandemic on Substance Use Disorders Risk among People Living with HIV Enrolled in HIV Care in the United States: an Interrupted Time Series Analysis\",\"authors\":\"Jennifer P Jain, Megan J Heise, Nadra E Lisha, Carlos H Moreira, David V Glidden, Greer A Burkholder, Heidi M Crane, Jeffrey M Jacobson, Edward R Cachay, Kenneth H Mayer, Sonia Napravnik, Richard D Moore, Carol Dawson-Rose, Mallory O Johnson, Katerina A Christopoulos, Monica Gandhi, Matthew A Spinelli\",\"doi\":\"10.1093/ofid/ofae491\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"With rising overdose deaths globally and the social isolation of the COVID-19 pandemic, people with HIV (PWH) with substance use disorders (SUD) may have been disproportionately impacted. 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A renewed investment in integrated substance use treatment is vital to address the combined epidemics of substance use and HIV following the COVID pandemic and to support resilience in the face of future disruptions.\",\"PeriodicalId\":19517,\"journal\":{\"name\":\"Open Forum Infectious Diseases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-08-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Forum Infectious Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ofid/ofae491\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae491","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
随着全球吸毒过量死亡人数的增加以及 COVID-19 大流行病造成的社会隔离,患有药物使用障碍(SUD)的艾滋病病毒感染者(PWH)可能受到了极大的影响。我们研究了在 COVID-19 就地庇护(SIP)授权前后,PWH 中的 SUD 风险是否发生了变化。我们在 2018-2022 年间收集了艾滋病研究中心(CFAR)综合临床系统网络(CNICS)队列中 8 个美国站点的 PWH 登记数据。我们使用混合效应逻辑回归模型进行间断时间序列分析,评估了 SIP 后报告的中度/高度 SUD 风险的变化。共有 7,126 名参与者,包括 21,741 次 SUD 评估。中位年龄为 51 岁(IQR=39-58);12% 为西班牙裔或拉丁裔;46% 为黑人/非裔美国人,46% 为白人。中度/高度 SUD 风险在大流行开始后持续增加,SIP 后有 43% (95%CI=40-46%) 的人认可中度/高度 SUD 风险,而 SIP 前只有 24% (95%CI=22-26%) 的人认可(p<.001)。据统计,SIP 后海洛因、甲基苯丙胺和芬太尼的使用量明显增加,而处方类阿片和镇静剂的使用量则有所减少。此外,与实施《综合方案》前相比,实施《综合方案》后报告的药物使用治疗次数明显减少(p=.025)。到 2022 年末,SDD 患病率的上升可能与大流行病造成的隔离、抑郁以及药物使用和 HIV 治疗机会的减少有关。要解决 COVID 大流行后药物使用和艾滋病毒的合并流行问题,并支持面对未来干扰的恢复能力,对综合药物使用治疗的新投资至关重要。
The Impact of the COVID-19 Pandemic on Substance Use Disorders Risk among People Living with HIV Enrolled in HIV Care in the United States: an Interrupted Time Series Analysis
With rising overdose deaths globally and the social isolation of the COVID-19 pandemic, people with HIV (PWH) with substance use disorders (SUD) may have been disproportionately impacted. We examined whether there was a change in SUD risk among PWH before and after the COVID-19 shelter-in-place (SIP) mandate. Data were collected between 2018-2022 among PWH enrolled across 8 U.S. sites in the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) cohort. We evaluated changes in reported moderate/high SUD risk after SIP using interrupted time series analyses fit with a mixed-effects logistic regression model. There were 7,126 participants, including 21,741 SUD assessments. The median age was 51 (IQR=39-58); 12% identified as Hispanic or Latino/a; 46% identified as Black/African American, and 46% White. Moderate/high SUD risk increased continuously after the pandemic’s onset, with 43% (95%CI=40-46%) endorsing moderate/high SUD risk post-SIP, compared to 24% (95%CI=22-26%) pre-SIP (p<.001). There were statistically significant increases in the use of heroin, methamphetamine, and fentanyl, and decreases in prescription opioids and sedatives post-SIP. Further, there was a significant decrease in reported substance use treatment post-SIP compared to pre-SIP, (p=.025). The rising prevalence of SUD through late 2022 could be related to an increase in isolation, depression, and reduced access to substance use and HIV treatment caused by disruptions due to the pandemic. A renewed investment in integrated substance use treatment is vital to address the combined epidemics of substance use and HIV following the COVID pandemic and to support resilience in the face of future disruptions.
期刊介绍:
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.