Publication Abstract Display
Type: Poster
Title: Effect of lifetime substance use disorders on neuropsychiatric distress among persons with and without HIV.
Authors: Kohli M, Kamalyan L, Saloner R, Watson CWM, Lobo J, Montoya JL, Umlauf A, Ellis RJ, Grant I, Moore DJ
Date: 06-21-2021
Abstract:Purpose: Substance use and HIV infection are independently associated with neuropsychiatric distress (e.g., depression, anxiety). We examined the association between a lifetime history of multiple substance use disorders (SUDs) and neuropsychiatric complaints among people with HIV (PWH) and HIV-negative (HIV–) people. We hypothesize that greater lifetime SUDs will be associated with worse neuropsychiatric outcomes in PWH and HIV– people. Methods: Participants included 114 PWH and 98 HIV– people. Participants completed the Profile of Mood States (POMS), a self-report measure of current neuropsychiatric distress with six subscales (i.e., Tension/Anxiety, Depression/Dejection, Anger/Hostility, Vigor/Activation, Fatigue/Inertia, Confusion/Bewilderment). A global distress score is calculated by summing five subscales and subtracting the Vigor/Activation score. Lifetime SUDs (i.e., alcohol, cannabis, cocaine, hallucinogen, inhalant, opioid, PCP, sedative, and methamphetamine) were assigned using the Composite International Diagnostic Interview. Multiple lifetime SUDs was continuously quantified as the number of different substances for which a SUD was diagnosed. Linear regressions examined the interaction between multiple lifetime SUDs and HIV status on POMS global distress and POMS subscale scores, covarying for relevant demographics (i.e., age, sex, race/ethnicity, and education). Results: The sample of PWH met lifetime criteria for a greater number of SUDs (M = 1.8, SD = 1.9) than the HIV- sample (M = 0.7, SD = 1.2; p < 0.001); specifically, higher rates of lifetime alcohol, methamphetamine, opioid, and sedative use disorders (ps < 0.05). Alcohol use disorder was the most prevalent SUD among PWH. PWH reported worse global distress (p < 0.001) and worse scores on all POMS subscales (ps < 0.05). A significant multiple SUD x HIV interaction occurred for Vigor/Activation (b = 1.4, p = 0.046) and Fatigue/Inertia (b = −1.7, p = 0.008); interactions for global distress (b = −7.1, p = 0.055) and Confusion/Bewilderment (b = −0.5, p = 0.064) approached significance. Higher counts of SUD related to worse global distress (b = −6.6, p = 0.012), Vigor/Activation (b = 1.5, p = 0.008), Fatigue/Inertia (b = −1.3, p = 0.007), and Confusion/Bewilderment (b = −0.8, p = 0.019) only among the HIV- group (ps > 0.05), not in PWH. Conclusions: HIV- adults exhibited a strong association between a history of SUDs and global neuropsychiatric distress. Despite reporting worse global distress, the association between multiple SUDs and neuropsychiatric distress was statistically non-significant among PWH, suggesting non-substance use factors may enhance perception of neuropsychiatric distress. Future research is warranted to investigate correlates of neuropsychiatric distress in PWH.

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