The prevalence and patterns of substance use by birth cohort among HIV-positive adults in Florida

ABSTRACT

Objectives: Antiretroviral therapy is affording longer lifespans for people living with HIV (PLWH), yet factors such as substance use play an increasing role in morbidity and mortality in this population. Though previous studies have examined substance use differences between age cohorts of PLWH, no study has examined the influence of birth cohort on current substance use patterns. Thus, this study investigated the prevalence of past 12-month self-reported substance use between four birth cohorts, <1970 (M age = 54.1), 1970s (M age = 41.5), 1980s (M age = 31.3 years old), and 1990s (M age = 23.2 years old) of PLWH in Florida.

Methods: PLWH (N = 934) recruited from community health clinics in Florida completed a questionnaire assessing sociodemographics, health status, and substance use.

Multivariate logistic regressions utilizing the <1970 cohort as the referent group examined the relationship between birth cohort and substance use.

Results: The 1980s cohort had significantly greater odds of marijuana use compared to the oldest cohort (<1970s), while the three younger cohorts (1970s, 1980s, and 1990s) evidenced a significantly greater odds of ecstasy use compared to the oldest group. Contrastingly, the three younger birth cohorts reported significantly less crack use than the oldest cohort, while the youngest group (1990s) also demonstrated an 80% reduction in injection drug use compared to the oldest group.

Conclusion: The older cohort evidenced significantly greater crack and injection drug use, while the younger cohorts evidenced greater marijuana and ecstasy use. Therefore, it is important to develop age-specific substance use interventions among PLWH.

KEYWORDS:

• HIV
• substance use
• aging
• interventions
• health policy

Acknowledgments

We greatly appreciate the contributions of the research staff and the participants who were involved in the Florida Cohort study. We also appreciate the contributions of the staff within the Florida Department of Health HIV Surveillance unit.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This study was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) [grant number U24AA022002]; National Institute on Drug Abuse (NIDA) [grant number 1K23DA039769-01]; NIDA UF Substance Abuse Training Center [grant number T32DA035167].