1545. The Impact of Illicit Drug Use on Viral Suppression and Retention in Care among HIV Positive Adolescents and Young Adults
Session: Poster Abstract Session: HIV Pediatric and Adolescents
Friday, October 28, 2016
Room: Poster Hall
Posters
  • DA Poster_A Thompson.pdf (292.2 kB)
  • Background: The National HIV/AIDS strategy calls for significant increases in the percentage of HIV+ persons retained in medical care (90%) and achieving viral suppression (80%). The state of Georgia has the 5th highest incident HIV case rate in the nation with 23% of new HIV infections among adolescent and young adults (AYA) ages 13-24. There is a paucity of data regarding the impact of illicit drug use (IDU) on HIV control and retention in care among AYAs. We sought to determine the prevalence of IDU in the HIV+ AYA population at the largest pediatric HIV clinic in Atlanta and the effects of IDU on HIV viral suppression and retention in HIV care.

    Methods: We administered a prospective survey to HIV+ AYAs between the ages of 13-24 from October 2013 to February 2016 to determine the prevalence of IDU, and evaluate the influence of IDU on care retention and viral suppression. Retention in care was defined as compliance with ≥90% of scheduled clinic visits in the 6 months prior to enrollment. Viral suppression was defined as a mean HIV-1 RNA viral load of <200 copies/ml in the same time period to account for viral blips. Logistic regression was used to evaluate IDU associations and identify other risk factors.

    Results: 200 participants were enrolled, with a mean age of 21±2.4 years. Forty six percent of participants admitted to current IDU, with marijuana as the most commonly used drug. Univariate analysis showed lack of viral suppression in AYAs with any IDU (OR=2.03, 95% CI: 1.15-3.58) and marginally with high school education or less (OR=1.71, 95% CI: 0.94-3.12). In the multivariable model, lack of viral suppression maintained associations with any IDU (aOR=2.09, 95% CI: 1.12-3.89) and a high school education or less (aOR=2.18, 95% CI: 1.14-4.19). AYAs who were retained in HIV care were less likely to have poor viral control (aOR=0.22, 95% CI: 0.10-0.50), but IDU was not associated with retention in HIV care (aOR=1.32, 95% CI: 0.69-2.54). Sub-analyses found marijuana use was associated with a lack of viral suppression (aOR=2.19, 95% CI: 1.17-4.07).

    Conclusion: High prevalence of IDU among HIV+ AYAs and its association with poor viral control demonstrates the need for interventions specifically designed for this population including strategies to decrease marijuana consumption.

    Amelia Thompson, MD, MPH1, Scott E. Gillespie, MS2, Jasper Hood, BA3, Lateshia Seaton, RN, BSN3 and Andres Camacho-Gonzalez, MD, MSc.1, (1)Department of Pediatrics, Division of Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA, (2)Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, (3)Ponce Family and Youth Clinic, Grady Infectious Diseases Program, Grady Health Systems, Atlanta, GA

    Disclosures:

    A. Thompson, None

    S. E. Gillespie, None

    J. Hood, None

    L. Seaton, None

    A. Camacho-Gonzalez, None

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