Correlates of Crack or Injection Drug Use Cessation among Canadians Coinfected with HIV and Hepatitis C

Crack and injection drug use are associated with worse treatment outcomes for both HIV and hepatitis C (HCV) infection and cessation facilitates better HIV and HCV care. Canadian researchers examined data from a cohort of 521 patients with HIV and HCV co-infection as well as crack and injection drug use to find factors associated with substance use cessation. The median follow-up time was 3 years.

• 69% of the cohort ceased drug use during follow-up.
• Having a fixed address (adjusted odds ratio [aOR], 1.73) and smoking crack without injecting (aOR, 3.10) were positively associated with cessation.
• Living alone (aOR, 0.47), current tobacco use (aOR, 0.41), hazardous alcohol consumption (aOR, 0.67), snorting drugs (aOR, 0.52), and cumulative episodes of addiction treatment (aOR, 0.88) were negatively associated with cessation.
• Age, education, duration of HIV infection, and care adherence were not associated with cessation.

Comments:

Among patients coinfected with HIV and HCV, crack and injection drug use cessation is common, but less likely to occur in patients living alone, with unstable housing, or those with the use of multiple substances (e.g., tobacco, alcohol, or other drugs). For patients with multiple treatment attempts, strategies for more effective treatment engagement may improve outcomes.

Alexander Y. Walley, MD, MSc

Reference:

Cox J, Maurais E, Hu L, et al. Correlates of drug use cessation among participants in the Canadian HIV–HCV Co-infection Cohort. Drug Alcohol Depend. 2014;137:121–128.