دورية أكاديمية
Treatment Initiation, Substance Use Trajectories, and the Social Determinants of Health in Persons Living With HIV Seeking Medication for Opioid Use Disorder.
| العنوان: | Treatment Initiation, Substance Use Trajectories, and the Social Determinants of Health in Persons Living With HIV Seeking Medication for Opioid Use Disorder. |
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| المؤلفون: | Cook RR; Department of Medicine, Section of Addiction Medicine, Oregon Health and Science University, Portland, OR, USA., Jaworski EN; Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois-Chicago, Chicago, IL, USA., Hoffman KA; Oregon Health and Science University-Portland State University School of Public Health, Portland, OR, USA., Waddell EN; Oregon Health and Science University-Portland State University School of Public Health, Portland, OR, USA., Myers R; Department of Medicine, Section of Addiction Medicine, Oregon Health and Science University, Portland, OR, USA., Korthuis PT; Department of Medicine, Section of Addiction Medicine, Oregon Health and Science University, Portland, OR, USA., Vergara-Rodriguez P; Ruth M. Rothstein CORE Center - Cook County Health, Chicago, IL, USA. |
| المصدر: | Substance abuse [Subst Abus] 2023 Oct; Vol. 44 (4), pp. 301-312. Date of Electronic Publication: 2023 Oct 16. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: SAGE Publications Country of Publication: United States NLM ID: 8808537 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1547-0164 (Electronic) Linking ISSN: 08897077 NLM ISO Abbreviation: Subst Abus Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2023 : [Thousand Oaks] : SAGE Publications Original Publication: Providence, RI : Center for Alcohol and Addiction Studies, Brown University, |
| مواضيع طبية MeSH: | Buprenorphine*/therapeutic use , HIV Infections*/drug therapy , Opioid-Related Disorders*/drug therapy, Female ; Humans ; Male ; Middle Aged ; Analgesics, Opioid/therapeutic use ; Opiate Substitution Treatment ; Social Determinants of Health |
| مستخلص: | Background: People living with HIV and opioid use disorder (OUD) are disproportionally affected by adverse socio-structural exposures negatively affecting health, which have shown inconsistent associations with uptake of medications for OUD (MOUD). This study aimed to determine whether social determinants of health (SDOH) were associated with MOUD uptake and trajectories of substance use in a clinical trial of people seeking treatment. Methods: Data are from a 2018 to 2019 randomized trial comparing the effectiveness of different MOUD to achieve viral suppression among people living with HIV and OUD. SDOH were defined by variables mapping to Healthy People 2030 domains: education (Education Access and Quality), income (Economic Stability), homelessness (Neighborhood and Built Environment), criminal justice involvement (Social and Community Context), and recent SUD care (Health Care Access and Quality). Associations between SDOH and MOUD initiation were assessed with Cox proportional hazards models, and SDOH and substance use over time with generalized estimating equation models. Results: Participants (N = 114) averaged 47 years old, 63% were male, 56% were Black, and 12% Hispanic. Participants reported an average of 2.3 out of 5 positive SDOH indicators (SD = 1.2). Stable housing was the most commonly reported SDOH (61%), followed by no recent criminal justice involvement (59%), having a high-school level education or greater (56%), income stability (45%), and recent SUD care (13%). Each additional favorable SDOH was associated with a 25% increase in the likelihood of MOUD initiation during the study period [adjusted HR = 1.25, 95% CI = (1.01, 1.55), P = .044]. Positive SDOH were also associated with a decrease in the odds of baseline opioid use and a greater reduction in opioid use during subsequent weeks of the study ( P < .001 for a joint test of baseline and slope differences). Conclusions: Positive social determinants of health, in aggregate, may increase the likelihood of MOUD treatment initiation among people living with HIV and OUD. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
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| معلومات مُعتمدة: | K01 DA055130 United States DA NIDA NIH HHS; U01 DA047982 United States DA NIDA NIH HHS; UG1 DA015815 United States DA NIDA NIH HHS; UG1 DA015831 United States DA NIDA NIH HHS |
| فهرسة مساهمة: | Keywords: HIV; medication for opioid use disorder; opioid use disorder; social determinants of health; substance use disorder |
| المشرفين على المادة: | 0 (Analgesics, Opioid) 40D3SCR4GZ (Buprenorphine) |
| تواريخ الأحداث: | Date Created: 20231016 Date Completed: 20231104 Latest Revision: 20240202 |
| رمز التحديث: | 20240202 |
| مُعرف محوري في PubMed: | PMC10830143 |
| DOI: | 10.1177/08897077231200745 |
| PMID: | 37842910 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1547-0164 |
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| DOI: | 10.1177/08897077231200745 |