Influence of substance use on cardiovascular risk factors and disease among HIV-positive clinic patients in NYC: Findings from electronic medical record data
Methods: Analyses were based on electronic medical records (EMRs) of 5,584 HIV-positive patients in NYC to examine the link between ADU problems using ICD-9/10 diagnoses of abuse/dependence and CVD risk factors by comparing four groups: no ADU problems (71.1%), alcohol only (3.8%), drug only (16.9%), and both ADU problems (8.2%).
Results: Most of the patients (79%) were men, 75% identified as Black or Latino, and the mean age was 46 years. Time since HIV diagnosis was 13 years on average, and 4% of patients had a CVD diagnosis. A significant number of both ADU and drug only patients had a documented CVD event (5.7% and 5.2%, respectively) compared to the no ADU problems and alcohol only groups (2.8% and 3.3%, respectively; p<.001). A significant number of patients with ADU problems also had detectable viral loads, AIDS diagnosis, hypertension, and smoked compared to the other groups (p<.001). After controlling for age, race, gender, time since HIV diagnosis, AIDS diagnosis, and viral load, the number of risk factors was greatest for the ADU group (Wald Chi-square=117.88, p<.001).
Conclusions: HIV-positive patients with ADU problems are at increased risk for CVD. Integrating substance use treatment into HIV care is critical to reduce CVD risk for a substantial number of people.
Learning Areas:Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related education
Public health or related organizational policy, standards, or other guidelines
Public health or related research
Social and behavioral sciences
Describe cardiovascular disease risk among HIV-positive patients with and without alcohol and drug-use problems. Examine sociodemographic differences in alcohol and drug-use problems among HIV-positive patients. Discuss clinical implications for behavioral interventions to improve health outcomes among HIV-positive individuals.
Keyword(s): HIV/AIDS, Heart Disease
Qualified on the content I am responsible for because: I have completed a medical degree and an MPH and I am the Project Director managing this research study. I have been conducting HIV-related research for the past four years.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.