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- Access to Care (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedRich KM, Zubiago J, Murphy M
The association of gender with receptive and distributive needle sharing among individuals who inject drugs.
The authors sought to assess the relationship between gender and needle sharing with injection drug use. Using data from the 2010-2019 National Survey on Drug Use and Health (NSDUH) datasets, they found that women were more likely in comparison with men to share needles both through receptive and distributive means. They concluded that expansion of interventions, including syringe service programs, to increase access to sterile injection equipment, is of great importance.
AHRQ-funded; HS026008.
Citation: Rich KM, Zubiago J, Murphy M .
The association of gender with receptive and distributive needle sharing among individuals who inject drugs.
Harm Reduct J 2022 Sep 30;19(1):108. doi: 10.1186/s12954-022-00689-3..
Keywords: Human Immunodeficiency Virus (HIV), Substance Abuse, Behavioral Health, Sex Factors
Korthuis PT, Cook RR, Lum PJ
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Opioid Use Disorder (OUD) treatment medications can improve outcomes for human immunodeficiency virus (HIV) and also reduce opioid use. The purpose of the study was to determine if outpatient naltrexone treatment could also reduce opioid use and improve outcomes for HIV. The researchers reported that enrollment was stopped early because of slower than expected recruitment, resulting in 114 final participants with untreated OUD and HIV, with 62% positive for fentanyl, 60% positive for cocaine, and 47% positive for other opioids at the baseline. The intervention compared treatment as usual (TAU) of methadone or buprenorphine with extended-release naltrexone (XR-NTX) on group differences in viral suppression at 24 weeks and past 30-day use of opioids at 24 weeks. The study reported that at 24 weeks the outcome of viral suppression was similar for TAU and XR-NTX, and that fewer XR-NTX participants initiated medication than TAU participants. The outcome of previous 30-day use of opioids was similar for TAU as compared to XR-NTX. Of those participants who did initiate medication, those administered XR-NTX experienced less days of opioid use when compared with TAU in the prior 30 days. The researchers reported that the study evidence was not conclusive but did support that XR-NTX is not inferior to TAU for HIV viral suppression, and that study participants who started XR-NTX used less opioids at 24 weeks than participants who were administered TAU.
AHRQ-funded; HS026370.
Citation: Korthuis PT, Cook RR, Lum PJ .
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Addiction 2022 Jul;117(7):1961-71. doi: 10.1111/add.15836..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Behavioral Health, Medication, Treatments, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Wyse JJ, McGinnis KA, Edelman EJ
Twelve-month retention in opioid agonist treatment for opioid use disorder among patients with and without HIV.
Although opioid agonist therapy (OAT) is associated with positive health outcomes, including improved HIV management, long-term retention in OAT remains low among patients with opioid use disorder (OUD). The investigators concluded that history of homelessness was associated with a lower likelihood of retention. Predictors of retention were largely distinct between patients with HIV and patients without HIV. Findings highlighted the need for clinical, systems, and research initiatives to better understand and improve OAT retention.
AHRQ-funded; HS026370.
Citation: Wyse JJ, McGinnis KA, Edelman EJ .
Twelve-month retention in opioid agonist treatment for opioid use disorder among patients with and without HIV.
AIDS Behav 2022 Mar;26(3):975-85. doi: 10.1007/s10461-021-03452-0..
Keywords: Opioids, Substance Abuse, Behavioral Health, Human Immunodeficiency Virus (HIV)
Cook RR, Torralva R, King C
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
This study examined the associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder (OUD) among people living with uncontrolled HIV disease. Data from a multisite clinical trial was used to compare extended-release naltrexone (XR-NTX) with treatment as usual (TAU: buprenorphine or methadone) to achieve HIV viral suppression among people with OUD and uncontrolled HIV disease. Exposure to fentanyl use was measured by urine drug screening. The cohort was 11 participants had an average age of 47 years, were 62% male, 57% Black and 13% Hispanic. Baseline fentanyl use was 64% for participants. Participants with baseline fentanyl use were 11 times less likely to initiative XR-NTX than those negative for fentanyl, but there was no evidence that fentanyl use impacted the likelihood of TAU initiation.
AHRQ-funded; HS026370.
Citation: Cook RR, Torralva R, King C .
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
Drug Alcohol Depend 2021 Nov 1;228:109077. doi: 10.1016/j.drugalcdep.2021.109077..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Human Immunodeficiency Virus (HIV), Chronic Conditions
Zubiago J, Murphy M, Guardado R
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
During the COVID-19 pandemic, due to lapses in harm reduction services, several public health experts forecasted subsequent increases in diagnosis of HIV in PWUD. As many inpatient hospitals reworked patient flow during the COVID-19 surge, the investigators hypothesized that HIV testing in PWUD would decrease. To answer this question, they compiled a deidentified list of hospitalized patients with electronic medical record indicators of substance use-a positive urine toxicology screen, prescribed medications to treat opioid use disorder, a positive CIWA score, or a positive CAGE score-admitted between January, 2020 and August, 2020.
AHRQ-funded; HS026008.
Citation: Zubiago J, Murphy M, Guardado R .
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
J Subst Abuse Treat 2021 May;124:108266. doi: 10.1016/j.jsat.2020.108266..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Alcohol Use, Hospitalization, COVID-19, Public Health, Screening
Tsui JI, Akosile MA, Lapham GT
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. The objective of this retrospective observational cohort study was to describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.
AHRQ-funded; HS026369.
Citation: Tsui JI, Akosile MA, Lapham GT .
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
J Gen Intern Med 2021 Apr;36(4):930-37. doi: 10.1007/s11606-020-06389-7..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Hepatitis, Human Immunodeficiency Virus (HIV), Primary Care
BJ BJ, McGinnis KA, Edelman EJ
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV.
Researchers examined predictors of medications for alcohol use disorder initiation and retention across HIV status. Data from the Veterans Aging Cohort Study data was used to identify new alcohol use disorder diagnoses among 163,339 individuals from 1998 to 2015. The researchers found that the low frequency of retention precluded multivariable analyses for retention. They concluded that, for people living with HIV and uninfected individuals, targeted implementation strategies to expand medications for alcohol use disorder are needed, particularly for specific subpopulations.
AHRQ-funded; HS021112.
Citation: BJ BJ, McGinnis KA, Edelman EJ .
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV.
J Subst Abuse Treat 2020 Feb;109:14-22. doi: 10.1016/j.jsat.2019.11.002..
Keywords: Alcohol Use, Substance Abuse, Medication, Human Immunodeficiency Virus (HIV)
Lipira L, Rao D, Nevin PE
Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV.
The authors used baseline data from a randomized controlled trial of an HIV-related stigma-reduction intervention among African-American women living with HIV in Chicago and Birmingham. They measured patterns of alcohol use, then assessed demographic, social, and clinical characteristics which may influence alcohol use and HIV-related outcomes which may be influenced by patterns of alcohol use. Their findings suggest that alcohol use is common and associated with poor HIV-related outcomes in this population. They recommended that regular alcohol screening and intervention be offered.
AHRQ-funded; HS013853.
Citation: Lipira L, Rao D, Nevin PE .
Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV.
Drug Alcohol Depend 2020 Jan 1;206:107753. doi: 10.1016/j.drugalcdep.2019.107753..
Keywords: Human Immunodeficiency Virus (HIV), Alcohol Use, Racial and Ethnic Minorities, Women, Substance Abuse
Rentsch CT, Edelman EJ, Justice AC
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
A better understanding of predisposition to transition to high-dose, long-term opioid therapy after initial opioid receipt could facilitate efforts to prevent opioid use disorder (OUD). In this study, the investigators extracted data on 69,268 patients in the Veterans Aging Cohort Study who received any opioid prescription between 1998 and 2015. They identified four distinguishable dose trajectories. The authors indicate that their measures could potentially be used in future prevention research, including genetic discovery.
AHRQ-funded; HS021112; HS023258.
Citation: Rentsch CT, Edelman EJ, Justice AC .
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
AIDS Behav 2019 Dec;23(12):3340-49. doi: 10.1007/s10461-019-02608-3..
Keywords: Opioids, Medication, Substance Abuse, Human Immunodeficiency Virus (HIV), Pain, Chronic Conditions
Stringer KL, Marotta P, Baker E
Substance use stigma and antiretroviral therapy adherence among a drug-using population living with HIV.
Among people living with HIV (PLWH), HIV-related stigma predicts nonadherence to antiretroviral therapy (ART); however, the role of stigma associated with drug use is largely unknown. The this study the investigators examined the association between substance use (SU) stigma and optimal ART adherence in a sample of 172 self-reported HIV-infected drug users.
AHRQ-funded; HS013852.
Citation: Stringer KL, Marotta P, Baker E .
Substance use stigma and antiretroviral therapy adherence among a drug-using population living with HIV.
AIDS Patient Care STDS 2019 Jun;33(6):282-93. doi: 10.1089/apc.2018.0311..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Patient Adherence/Compliance, Medication, Substance Abuse
Hill LM, Golin CE, Gottfredson NC
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
The purpose of this study was to identify the mechanisms involved with antiretroviral therapy (ART) non-adherence among people living with HIV (PLHIV) after release from prison. Results showed that, on average, study participants achieved 79% ART adherence. Greater symptoms of depression were associated with greater drug use, which was in turn associated with lower adherence. Lower adherence self-efficacy was associated with depressive symptoms, but not with adherence. Results suggested that depression screening and targeted mental health and substance use services for depressed individuals at risk of substance use constitute important steps to promote adherence to ART after prison release.
AHRQ-funded; HS000032.
Citation: Hill LM, Golin CE, Gottfredson NC .
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
AIDS Behav 2019 Aug;23(8):2037-47. doi: 10.1007/s10461-018-2355-3..
Keywords: Behavioral Health, Depression, Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Substance Abuse, Vulnerable Populations
Aggarwal R, Pham M, Dillingham R
Expanded HIV clinic-based mental health care services: association with viral suppression.
This study compared two cohorts of people living with HIV (PLWH) who were receiving clinic-based mental health services. Cohort A received the services before or during 2012, and Cohort B from 2013-2014. Cohort A had three times as many participants with a CD4 count <200. Cohort B were more likely to also have a substance abuse diagnosis. The researchers concluded that the later cohort may not have as much benefit from increased access to co-located mental health services and substance use services.
AHRQ-funded; HS024196.
Citation: Aggarwal R, Pham M, Dillingham R .
Expanded HIV clinic-based mental health care services: association with viral suppression.
Open Forum Infect Dis 2019 Apr;6(4):ofz146. doi: 10.1093/ofid/ofz146..
Keywords: Access to Care, Behavioral Health, Community-Based Practice, Human Immunodeficiency Virus (HIV), Substance Abuse
Young LE, Michaels S, Jonas A
Sex behaviors as social cues motivating social venue patronage among young black men who have sex with men.
This study presents a two-mode network analysis that determines the extent that three types of sex behaviors-condomless sex, sex-drug use, and group sex-influence the patronage of different types of social venues among a population sample of young Black men who have sex with men. Its findings demonstrate that social venues can function as intermediary contexts in which relationships can form between individuals that have greater risk potential.
AHRQ-funded; HS000084.
Citation: Young LE, Michaels S, Jonas A .
Sex behaviors as social cues motivating social venue patronage among young black men who have sex with men.
AIDS Behav 2017 Oct;21(10):2924-34. doi: 10.1007/s10461-017-1679-8.
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Keywords: Lifestyle Changes, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Substance Abuse
Morgan E, Khanna AS, Skaathun B
Marijuana use among young black men who have sex with men and the HIV care continuum: findings from the uConnect cohort.
The authors investigated how substances most commonly used by young black men who have sex with men (YBMSM), such as marijuana, are related to the HIV continuum. They found that YBMSM who used marijuana heavily were more likely to be HIV-positive unaware than those who never used marijuana..
AHRQ-funded; HS000084.
Citation: Morgan E, Khanna AS, Skaathun B .
Marijuana use among young black men who have sex with men and the HIV care continuum: findings from the uConnect cohort.
Subst Use Misuse 2016 Nov 9;51(13):1751-9. doi: 10.1080/10826084.2016.1197265.
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Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Racial and Ethnic Minorities, Substance Abuse
Palar K, Laraia B, Tsai AC
Food insecurity is associated with HIV, sexually transmitted infections and drug use among men in the United States.
The researchers examined the population-level association between food insecurity, HIV risk factors, and HIV serostatus among men. They found that food insecurity is associated with prevalent HIV, STIs, and illicit drug use among men in the United States.
AHRQ-funded; HS000046.
Citation: Palar K, Laraia B, Tsai AC .
Food insecurity is associated with HIV, sexually transmitted infections and drug use among men in the United States.
AIDS 2016 Jun 1;30(9):1457-65. doi: 10.1097/qad.0000000000001095.
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Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Men's Health, Nutrition, Substance Abuse
Depp TB, McGinnis KA, Kraemer K
Risk factors associated with acute exacerbation of chronic obstructive pulmonary disease in HIV-infected and uninfected patients.
This study sought to determine the association between HIV infection and other risk factors for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). It concluded that HIV infection, especially with lower CD4 cell count, is an independent risk factor for AECOPD. Enhanced susceptibility to harm from current smoking or unhealthy alcohol use in HIV-infected patients may also contribute to the greater rate of AECOPD.
AHRQ-funded; HS023258.
Citation: Depp TB, McGinnis KA, Kraemer K .
Risk factors associated with acute exacerbation of chronic obstructive pulmonary disease in HIV-infected and uninfected patients.
AIDS 2016 Jan 28;30(3):455-63. doi: 10.1097/qad.0000000000000940.
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Keywords: Respiratory Conditions, Human Immunodeficiency Virus (HIV), Risk, Substance Abuse, Tobacco Use
Earnshaw VA, Smith LR, Cunningham CO
Intersectionality of internalized HIV stigma and internalized substance use stigma: implications for depressive symptoms.
The researchers examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. They found that participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Smith LR, Cunningham CO .
Intersectionality of internalized HIV stigma and internalized substance use stigma: implications for depressive symptoms.
J Health Psychol 2015 Aug;20(8):1083-9. doi: 10.1177/1359105313507964..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Behavioral Health, Social Stigma, Substance Abuse