324. Current Alcohol and Substance Use in HIV-infected and HIV/HCV-co-infected Patients in Routine Clinical Care across the U.S
Session: Poster Abstract Session: HIV Co-morbidities
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Background: Little is known about how prevalence and patterns of alcohol and substance use differ among HIV-mono-infected and HIV/HCV-co-infected patients in the current treatment era. Most prior studies did not distinguish between current and past use, or examine individual illicit substances.

Methods: CNICS patients completed a touch-screen-based assessment including alcohol and substance use as part of clinical care. The most recent assessment data (from 5 sites: Seattle, Boston, Birmingham, San Diego, San Francisco) was used to measure substance use, including current at-risk alcohol use, amphetamine/crystal, cocaine/crack, heroin/opiate, or marijuana use, and assess patterns of concurrent substance use in HIV mono-infected and co-infected patients, using chi-squared tests. At risk alcohol use was defined as those who had a score ≥ 4 for men and ≥ 3 for women as measured by the AUDIT-C (Alcohol Use Disorders Identification Test Consumption).

Results:

Alcohol and substance use were examined among 5881 HIV mono-infected and 1155 HIV/HCV co-infected patients. Among all 7036 HIV infected patients, 24% reported at-risk alcohol use. Current substance use other than alcohol was higher among those with at-risk alcohol use vs. those without alcohol use (52 vs. 34%, p < 0.01), with prevalence more than double for all 4 illicit drug classes.

Current amphetamine, cocaine, opiate, and marijuana use was significantly higher in co-infected vs. mono-infected patients (p values all < 0.01). Fewer co-infected patients reported no current drug use vs. mono-infected patients (40 vs. 56%, p < 0.01), and were more likely to report 2 or more concurrent drugs (24 vs. 11%, p < 0.01). In contrast, at-risk alcohol use was lower among co-infected patients (19 vs. 25%, p < 0.01).

Conclusion: Patterns of substance use differ among HIV mono- and co-infected patients. These findings demonstrate the importance of evaluating individual substances, and distinguishing between current and past use. While at-risk alcohol use was lower among co-infected patients, 1 in 5 co-infected patients in clinical care reported current at-risk alcohol use. Greater focus on at-risk alcohol, and concurrent drug use, and additional targeted resources for addiction treatment/interventions are needed.

Jennifer C Ling, MD1, Carla V. Rodriguez, PhD2, Matthew Mimiaga, MPH, ScD3, Kenneth Mayer, MD4, Joseph Merrill, MD, MPH5, David Pantalone, PhD6, Geetanjali Chander, MD, MPH7, Mary E Mccaul, PhD7, Heidi Hutton, PhD7, Karen Cropsey, PsyD8, Michael J. Mugavero, MD, MHSc8, Katerina A Christopoulos, MD MPH9, W. Christopher Mathews, MD, MSPH10, Greer A. Burkholder, MD11, Michael S. Saag, MD12, Mari Kitahata, MD, MPH13, Heidi M. Crane, MD, MPH14 and CNICS (CFAR Network of Integrated Clinical Systems) cohort, (1)Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, (2)Center for AIDS Research, University of Washington, Seattle, WA, (3)Psychiatry, Fenway Health/Massachusetts General Hospital/Harvard School of Public Health, Boston, MA, (4)The Miriam Hospital, Providence, RI, (5)Division of General Internal Medicine, University of Washington, Seattle, WA, (6)University of Massachusetts Boston, Boston, MA, (7)Johns Hopkins University, Baltimore, MD, (8)University of Alabama at Birmingham, Birmingham, AL, (9)University of California San Francisco, San Francisco, CA, (10)University of San Diego, San Diego, CA, (11)Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, (12)University of Alabama, Birmingham, AL, (13)Medicine, Center for AIDS Research, University of Washington, Seattle, WA, (14)Medicine/Infectious Diseases, University of Washington, Seattle, WA

Disclosures:

J. C. Ling, None

C. V. Rodriguez, None

M. Mimiaga, None

K. Mayer, None

J. Merrill, None

D. Pantalone, None

G. Chander, None

M. E. Mccaul, None

H. Hutton, None

K. Cropsey, None

M. J. Mugavero, None

K. A. Christopoulos, None

W. C. Mathews, None

G. A. Burkholder, None

M. S. Saag, None

M. Kitahata, None

H. M. Crane, None

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