Current Drug Use and Lack of HIV Virologic Suppression: Point-of-care Urine Drug Screen Versus Self-report

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2014 Sep 20

PMID 25234368

Citations 10

Authors

Han-Zhu Qian

Valerie J Mitchell

Sally Bebawy

Holly Cassell

Gina Perez

Catherine C McGowan

Timothy R Sterling

Sten H Vermund

Richard DAquila

Todd Hulgan

Affiliations

Soon will be listed here.

Abstract

Background: There have been inconsistent findings on the association between current drug use and HIV disease progression and virologic suppression. Drug use was often measured using self-report of historical use. Objective measurement of current drug use is preferred.

Methods: In this cross-sectional study, we assessed drug use through Computer-Assisted Self Interviews (CASI) and point-of-care urine drug screen (UDS) among 225 HIV-infected patients, and evaluated the association between current drug use and virologic suppression.

Results: About half (54%) of participants had a positive UDS, with a lower self-reported rate by CASI (42%) (Kappa score = 0.59). By UDS, 36.0% were positive for marijuana, 25.8% for cocaine, 7.6% for opiates, and 2.2% for methamphetamine or amphetamine. Factors associated with virologic suppression (plasma HIV RNA <50 copies/mL) were Caucasian race (P = 0.03), higher CD4 count (P < 0.01), current use of antiretroviral therapy (ART) (P < 0.01), and a negative UDS (P < 0.01). Among 178 current ART users, a positive UDS remained significantly associated with lower likelihood of virologic suppression (P = 0.04).

Conclusions: UDS had good agreement with CASI in detecting frequently used drugs such as marijuana and cocaine. UDS at routine clinic visits may provide "real-time" prognostic information to optimize management.

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References

Peace M, Tarnai L, Poklis A . Performance evaluation of four on-site drug-testing devices for detection of drugs of abuse in urine. J Anal Toxicol. 2000; 24(7):589-94. DOI: 10.1093/jat/24.7.589. View

Smith M, Shimomura E, Summers J, Paul B, Nichols D, Shippee R . Detection times and analytical performance of commercial urine opiate immunoassays following heroin administration. J Anal Toxicol. 2000; 24(7):522-9. DOI: 10.1093/jat/24.7.522. View

Gribble J, Miller H, Rogers S, Turner C . Interview Mode and Measurement of Sexual Behaviors: Methodological Issues. J Sex Res. 2012; 36(1):16-24. PMC: 3516293. DOI: 10.1080/00224499909551963. View

Holler J, Bosy T, Klette K, Wiegand R, Jemionek J, Jacobs A . Comparison of the Microgenics CEDIA heroin metabolite (6-AM) and the Roche Abuscreen ONLINE opiate immunoassays for the detection of heroin use in forensic urine samples. J Anal Toxicol. 2004; 28(6):489-93. DOI: 10.1093/jat/28.6.489. View

Liu H, Golin C, Miller L, Hays R, Beck C, Sanandaji S . A comparison study of multiple measures of adherence to HIV protease inhibitors. Ann Intern Med. 2001; 134(10):968-77. DOI: 10.7326/0003-4819-134-10-200105150-00011. View

Westergaard R, Ambrose B, Mehta S, Kirk G . Provider and clinic-level correlates of deferring antiretroviral therapy for people who inject drugs: a survey of North American HIV providers. J Int AIDS Soc. 2012; 15(1):10. PMC: 3306203. DOI: 10.1186/1758-2652-15-10. View

Perez-Hoyos S, Del Amo J, Muga R, Del Romero J, Garcia de Olalla P, Guerrero R . Effectiveness of highly active antiretroviral therapy in Spanish cohorts of HIV seroconverters: differences by transmission category. AIDS. 2003; 17(3):353-9. DOI: 10.1097/00002030-200302140-00009. View

Chaisson R, Keruly J, Moore R . Race, sex, drug use, and progression of human immunodeficiency virus disease. N Engl J Med. 1995; 333(12):751-6. DOI: 10.1056/NEJM199509213331202. View

Zaldivar Basurto F, Garcia Montes J, Flores Cubos P, Sanchez Santed F, Lopez Rios F, Molina Moreno A . Validity of the self-report on drug use by university students: correspondence between self-reported use and use detected in urine. Psicothema. 2009; 21(2):213-9. View

10.

Islam M, Topp L, Conigrave K, van Beek I, Maher L, White A . The reliability of sensitive information provided by injecting drug users in a clinical setting: clinician-administered versus audio computer-assisted self-interviewing (ACASI). AIDS Care. 2012; 24(12):1496-503. DOI: 10.1080/09540121.2012.663886. View

11.

Qian H, Stinnette S, Rebeiro P, Kipp A, Shepherd B, Samenow C . The relationship between injection and noninjection drug use and HIV disease progression. J Subst Abuse Treat. 2011; 41(1):14-20. PMC: 3110534. DOI: 10.1016/j.jsat.2011.01.007. View

12.

Kipp A, Desruisseau A, Qian H . Non-injection drug use and HIV disease progression in the era of combination antiretroviral therapy. J Subst Abuse Treat. 2011; 40(4):386-96. PMC: 3081970. DOI: 10.1016/j.jsat.2011.01.001. View

13.

Hutton H, Lyketsos C, Zenilman J, Thompson R, Erbelding E . Depression and HIV risk behaviors among patients in a sexually transmitted disease clinic. Am J Psychiatry. 2004; 161(5):912-4. DOI: 10.1176/appi.ajp.161.5.912. View

14.

Bush K, Kivlahan D, McDonell M, Fihn S, Bradley K . The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998; 158(16):1789-95. DOI: 10.1001/archinte.158.16.1789. View

15.

Johnson T, Fendrich M . Modeling sources of self-report bias in a survey of drug use epidemiology. Ann Epidemiol. 2005; 15(5):381-9. DOI: 10.1016/j.annepidem.2004.09.004. View

16.

Chesney M, Ickovics J, Chambers D, Gifford A, Neidig J, Zwickl B . Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group.... AIDS Care. 2000; 12(3):255-66. DOI: 10.1080/09540120050042891. View

17.

Hahn J, Samet J . Alcohol and HIV disease progression: weighing the evidence. Curr HIV/AIDS Rep. 2010; 7(4):226-33. PMC: 2938419. DOI: 10.1007/s11904-010-0060-6. View

18.

Kapadia F, Cook J, Cohen M, Sohler N, Kovacs A, Greenblatt R . The relationship between non-injection drug use behaviors on progression to AIDS and death in a cohort of HIV seropositive women in the era of highly active antiretroviral therapy use. Addiction. 2005; 100(7):990-1002. PMC: 3128378. DOI: 10.1111/j.1360-0443.2005.01098.x. View

19.

McMahon J, Manoharan A, Wanke C, Mammen S, Jose H, Malini T . Pharmacy and self-report adherence measures to predict virological outcomes for patients on free antiretroviral therapy in Tamil Nadu, India. AIDS Behav. 2013; 17(6):2253-9. PMC: 3674125. DOI: 10.1007/s10461-013-0436-x. View

20.

Chander G, Himelhoch S, Fleishman J, Hellinger J, Gaist P, Moore R . HAART receipt and viral suppression among HIV-infected patients with co-occurring mental illness and illicit drug use. AIDS Care. 2009; 21(5):655-63. PMC: 2727701. DOI: 10.1080/09540120802459762. View