Measures of Physical and Mental Independence Among HIV-Positive Individuals: Impact of Substance Use Disorder.
Title | Measures of Physical and Mental Independence Among HIV-Positive Individuals: Impact of Substance Use Disorder. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Christensen, B, Qin, Z, Byrd, DA, Yu, F, Morgello, S, Gelman, BB, Moore, DJ, Grant, I, Singer, EJ, Fox, HS, Baccaglini, L |
Journal | AIDS Res Hum Retroviruses |
Volume | 33 |
Issue | 10 |
Pagination | 1048-1055 |
Date Published | 2017 Oct |
ISSN | 1931-8405 |
Keywords | Activities of Daily Living, Anti-HIV Agents, Female, HIV Infections, Humans, Male, neurocognitive disorders, Proportional Hazards Models, Risk Factors, Substance-Related Disorders |
Abstract | With the transition of HIV infection from an acute to a chronic disease after the introduction of antiretroviral medications, there has been an increased focus on long-term neurocognitive and other functional outcomes of HIV patients. Thus, we assessed factors, particularly history of a substance use disorder, associated with time to loss of measures of physical or mental independence among HIV-positive individuals. Data were obtained from the National NeuroAIDS Tissue Consortium. Kaplan-Meier and Cox proportional hazards regression analyses were used to estimate the time since HIV diagnosis to loss of independence, and to identify associated risk factors. HIV-positive participants who self-identified as physically (n = 698) or mentally (n = 616) independent on selected activities of daily living at baseline were eligible for analyses. A history of substance use disorder was associated with a higher hazard of loss of both physical and mental independence [adjusted hazard ratio (HR) = 1.71, 95% confidence interval (95% CI): 1.07-2.78; adjusted HR = 1.67, 95% CI: 1.11-2.52, respectively]. After adjusting for substance use disorder and other covariates, older age at diagnosis and female gender were associated with higher hazards of loss of both physical and mental independence, non-white participants had higher hazards of loss of physical independence, whereas participants with an abnormal neurocognitive diagnosis and fewer years of education had higher hazards of loss of mental independence. In summary, history of substance use disorder was associated with loss of measures of both physical and mental independence. The nature of this link and the means to prevent such loss of independence need further investigation. |
DOI | 10.1089/AID.2016.0269 |
Alternate Journal | AIDS Res Hum Retroviruses |
PubMed ID | 28288515 |
PubMed Central ID | PMC5650716 |
Grant List | U24 MH100929 / MH / NIMH NIH HHS / United States U24 MH100925 / MH / NIMH NIH HHS / United States U24 MH100931 / MH / NIMH NIH HHS / United States U24 MH100928 / MH / NIMH NIH HHS / United States U54 GM115458 / GM / NIGMS NIH HHS / United States P30 GM106397 / GM / NIGMS NIH HHS / United States P30 MH062512 / MH / NIMH NIH HHS / United States P30 GM103509 / GM / NIGMS NIH HHS / United States U24 MH100930 / MH / NIMH NIH HHS / United States |