Résumé
Background: The evidence to date on whether HIV infection increases the risk of accidental drug overdose among people who inject drugs (PWID) is equivocal. Thus, we sought to estimate the effect of HIV infection on risk of non-fatal overdose among two parallel cohorts of HIV-positive and -negative PWID. Methods: Data were collected from a prospective cohort of PWID in Vancouver, Canada between 2006 and 2013. During biannual follow-up assessments, non-fatal overdose within the previous 6 months was assessed. Bivariable and multivariable generalized mixed-effects regression models were used to determine the unadjusted and adjusted associations between HIV status, plasma HIV-1 RNA viral load, and likelihood of non-fatal overdose. Results: A total of 1760 eligible participants (67% male, median age = 42, and 42% HIV-positive at baseline) were included. Among 15,070 unique observations, 649 (4.3%) included a report of a non-fatal overdose within the previous 6 months (4.4% among seropositive and 4.3% among seronegative individuals). We did not observe a difference in the likelihood of overdose by HIV serostatus in crude (odds ratio [OR]: 1.05, p = 0.853) analyses or analyses adjusted for known overdose risk factors (adjusted OR [AOR]: 1.19, p = 0.474). In a secondary analysis, among HIV-positive PWID, we did not observe an association between having a detectable viral load and overdose (AOR: 1.03, p = 0.862). Conclusions: Despite the evidence that HIV infection is a risk factor for fatal overdose, we found no evidence for a relationship between HIV disease and non-fatal overdose. However, overdose remains high among PWID, indicating the need for ongoing policy addressing this problem, and research into understanding modifiable risk factors that predict non-fatal overdose.
| Langue d'origine | English |
|---|---|
| Pages (de-à) | 8-12 |
| Nombre de pages | 5 |
| Journal | Addictive Behaviors |
| Volume | 60 |
| DOI | |
| Statut de publication | Published - sept. 1 2016 |
| Publié à l'externe | Oui |
Note bibliographique
Funding Information:The authors thank the study participants for their contribution to the research, as well as current and past researchers and staff. The study was supported by the US National Institutes of Health (VIDUS: R01DA011591 , U01DA038886 ; ACCESS: R01DA021525 ). This research was undertaken, in part, thanks to funding from the Canada Research Chairs program through a Tier 1 Canada Research Chair in Inner City Medicine which supports Dr. Evan Wood. Dr. Milloy is supported in part by the United States National Institutes of Health (R01-DA021525). Dr. Montaner is supported by the British Columbia Ministry of Health and through an Avant-Garde Award (DP1-DA026182) from the National Institute of Drug Abuse (NIDA), at the US National Institutes of Health (NIH). He has also received financial support from the International AIDS Society, United Nations AIDS Program, World Health Organization, National Institutes of Health Research-Office of AIDS Research, National Institute of Allergy & Infectious Diseases, The United States President's Emergency Plan for AIDS Relief (PEPfAR), UNICEF, the University of British Columbia, Simon Fraser University, Providence Health Care and Vancouver Coastal Health Authority. Daniel Escudero is supported by the National Institute on Drug Abuse (F31-DA037808-01). Dr. Hayashi is supported by the Canadian Institutes of Health Research.
Publisher Copyright:
© 2016.
ASJC Scopus Subject Areas
- Medicine (miscellaneous)
- Clinical Psychology
- Toxicology
- Psychiatry and Mental health
PubMed: MeSH publication types
- Journal Article
ODD de l’ONU
Cette action contribue à la réalisation des objectifs de développement durable suivants
