Opioid misuse among persons with HIV engaged in care in the Southeastern US

ABSTRACT

The prevalence of opioid misuse by people living with HIV (PLWH) during the current US opioid epidemic has not been fully described. Among a cohort of persons engaged in HIV care in North Carolina, we examined the prevalence of and risk factors for opioid misuse, defined as self-reported “street” opioid use (e.g., heroin) or nonmedical prescription opioid use on a patient reported outcomes survey. Recent (past three-month) opioid misuse among 1,440 PLWH in care 2012–2017 was 2% (95% CI 2-3%) and lifetime misuse 15% (13-16%). Persons reporting lifetime or recent misuse more commonly had hepatitis C and reported injecting drugs. In multivariable logistic regression models, male-to-male sexual contact was inversely associated with recent or lifetime misuse. White/non-Hispanic race/ethnicity was associated with lifetime misuse and CD4 count and viral load were not associated with opioid misuse. Among 32 persons reporting recent misuse, 81% had a contemporaneous viral load <50 copies/mL. In this cohort of PLWH engaged in care, recent opioid misuse prevalence was similar to general population estimates. Assessments of opioid misuse among PLWH not in care are urgently needed to fully characterize the impact of opioids on all PLWH.

KEYWORDS:

• HIV
• opioids
• survey

Disclosure statement

JJE is ad hoc consultant to ViiV healthcare, Gilead Sciences, Merck and Janssen; and investigator on research contracts to the University of North Carolina from ViiV Healthcare, Gilead Sciences and Janssen. All other authors declare no conflicts.

Additional information

Funding

This work was supported by the National Institutes of Health, including the following grants: UNC Center for AIDS Research grant P30AI50410 and the Center for AIDS Research Network of Integrated Clinical Systems grant R24AI067039. AJS is supported by the National Institute of Allergy and Infectious Diseases (T32AI070114). TD is supported by the National Institute of Allergy and Infectious Diseases (T32AI007001).