@article{b5c3fa55a90f456b97d69af5435434fa,
title = "Influence of Substance Use Disorders on 2-Year HIV Care Retention in the United States",
abstract = "Substance use disorders (SUDs) are thought to predict care discontinuity, though magnitude and substance-specific variance of effects are unclear. This report of analytic work undertaken with a multi-regional American cohort of 9153 care enrollees addresses these gaps. Care retention was computed from 24-month post-linkage clinic visit documentation, with SUD cases identified from patient-report screening instruments. Two generalized estimating equations tested binary and hierarchial SUD predictors of retention, and potential effect modification by patient age-group, sex, and care site. Findings demonstrate: (1) detrimental SUD effect, equivalent to a nine percentage-point decrease in retention, with independent effects of age-group and care site; (2) substance-specific effect of marijuana UD associated with lower retention; and (3) age-modification of each effect on care discontinuity, with SUDs serving as a risk factor among 18–29 year-olds and protective factor among 60+ year-olds. Collective findings document patient attributes as influences that place particular subgroups at-risk to discontinue care.",
keywords = "Care retention, HIV care settings, Substance use disorders, United States",
author = "Bryan Hartzler and Dombrowski, {Julia C.} and Williams, {Jason R.} and Crane, {Heidi M.} and Eron, {Joseph J.} and Geng, {Elvin H.} and Christopher Mathews and Mayer, {Kenneth H.} and Moore, {Richard D.} and Mugavero, {Michael J.} and Sonia Napravnik and Benigno Rodriguez and Donovan, {Dennis M.}",
note = "Funding Information: The funding source for this analytic work was National Institute on Drug Abuse R03DA039719 (Informing Dissemination of Behavior Therapies to Enhance HIV Care Among Substance Abusers, Hartzler PI). The authors thank the CNICS sites for contributing data to this endeavor. CNICS is funded by R24 AI067039 with sites at University of Alabama at Birmingham, University of Washington, University of California San Diego, University of California San Francisco, Case Western Reserve University, John Hopkins University, Fenway Health/Harvard, and University of North Carolina Chapel Hill. The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health. Julia C. Dombrowski has conducted STD clinical research unrelated to this work supported by grants to the University of Washington from Genentech, ELITech, Melinta Therapeutics, Curatek Pharmaceuticals, Quidel, and Hologic. Among the authorship group, no other conflicts of interest were declared. Funding Information: Conflict of interest Julia C. Dombrowski has conducted STD clinical research unrelated to this work supported by grants to the University of Washington from Genentech, ELITech, Melinta Therapeutics, Curatek Pharmaceuticals, Quidel, and Hologic. Among the authorship group, no other conflicts of interest were declared. Publisher Copyright: {\textcopyright} 2017, Springer Science+Business Media, LLC.",
year = "2018",
month = mar,
day = "1",
doi = "10.1007/s10461-017-1826-2",
language = "English (US)",
volume = "22",
pages = "742--751",
journal = "AIDS and Behavior",
issn = "1090-7165",
publisher = "Springer New York",
number = "3",
}