Abstract:
:Persons living with HIV (PLWH) with substance use disorders (SUD) remain a population difficult to engage in HIV care. Project HOPE (Hospital Visits as an Opportunity for Prevention and Engagement), a randomized controlled trial testing patient navigation with/without contingency management for PLWH with SUD, aimed to address this disparity. PLWH with SUD who were out of care were recruited from 11 hospitals across the United States from 2012 to 2014. Baseline socioeconomic factors, medical mistrust scores, and perceived discrimination surveys were collected at enrollment and evaluated for effects on linkage to care at the 6-month follow-up assessment. Linkage to care (attending an outpatient visit for HIV care), early linkage to care (attending first visit within 30 days of enrollment), and engagement in care (two HIV visits within the 6-month period) were determined by medical record abstraction, supplemented by self-report. Among 801 participants enrolled in the study (mean age 45 years, 33% women, and 73% African American), those who did not complete high school and with severe food insecurity had lower odds of being linked to care at 6 months. Those with high levels of medical mistrust, recent drug use, and who did not complete high school had lower odds of early linkage to care. Early linkage was associated with higher odds of engagement at 6 months and was mitigated by both patient navigator interventions (all p < .05). Addressing social determinants of health is critical to correct the disparity seen in HIV outcomes among PLWH with SUD. Identifying factors that alter the effect of interventions could help identify patients who would benefit most.
journal_name
AIDS Res Hum Retrovirusesjournal_title
AIDS research and human retrovirusesauthors
Summers NA,Colasanti JA,Feaster DJ,Armstrong WS,Rodriguez A,Jain MK,Jacobs P,Metsch LR,Del Rio Cdoi
10.1089/AID.2019.0153subject
Has Abstractpub_date
2020-05-01 00:00:00pages
406-414issue
5eissn
0889-2229issn
1931-8405journal_volume
36pub_type
杂志文章abstract::Many human immunodeficiency virus (HIV) proteins including Tat are produced by HIV-infected astrocytes and secreted into the brain resulting in extensive neuronal damage that contributes to the pathogenesis of HIV dementia. The neuroprotective hormone 17beta-estradiol (E2) is known to negatively regulate the HIV trans...
journal_title:AIDS research and human retroviruses
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journal_title:AIDS research and human retroviruses
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journal_title:AIDS research and human retroviruses
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pub_type: 杂志文章
doi:10.1089/AID.2015.0170
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journal_title:AIDS research and human retroviruses
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章,多中心研究,随机对照试验
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