4.4 Article

Patterns of drug use and abuse among aging adults with and without HIV: A latent class analysis of a US Veteran cohort

Journal

DRUG AND ALCOHOL DEPENDENCE
Volume 110, Issue 3, Pages 208-220

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2010.02.020

Keywords

Aging; Veterans; HIV; Substance-related disorders; Latent class analysis; Illicit drugs; Cohort studies

Funding

  1. National Institutes of Health, National Institute on Drug Abuse [1F31DA023862-01A1]
  2. National Institute on Alcohol Abuse and Alcoholism [U10 AA 13566]
  3. VHA Public Health Strategic Health Core Group

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This study characterized the extent and patterns of self-reported drug use among aging adults with and without HIV, assessed differences in patterns by HIV status, and examined pattern correlates. Data derived from 6351 HIV-infected and uninfected adults enrolled in an eight-site matched cohort, the Veterans Aging Cohort Study (VACS). Using clinical variables from electronic medical records and socio-demographics, drug use consequences, and frequency of drug use from baseline surveys, we performed latent class analyses (LCA) stratified by HIV status and adjusted for clinical and socio-demographic covariates. Participants were, on average, age 50 (range 22-86), primarily male (95%) and African-American (64%). Five distinct patterns emerged: non-users, past primarily marijuana users, past multidrug users, current high consequence multidrug users, and current low consequence primarily marijuana users. HIV status strongly influenced class membership. Non-users were most prevalent among HIV uninfected (36.4%) and current high consequence multidrug users (25.5%) were most prevalent among HIV-infected. While problems of obesity marked those not currently using drugs, current users experienced higher prevalences of medical or mental health disorders. Multimorbidity was highest among past and current multidrug users. HIV-infected participants were more likely than HIV-uninfected participants to be current low consequence primarily marijuana users. In this sample, active drug use and abuse were common. HIV-infected and uninfected Veterans differed on extent and patterns of drug use and on important characteristics within identified classes. Findings have the potential to inform screening and intervention efforts in aging drug users with and without HIV. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

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