Publication Abstract Display
Type: Poster
Title: Effects of lifetime methamphetamine and alcohol use disorder and socioeconomic status on HIV-related quality of life.
Authors: Kamalyan L, Ham L, Umlauf A, Kohli M, Franklin DR, Letendre SL, Grant I, the CHARTER group
Date: 06-20-2021
Abstract:Purpose: To investigate the influence of combination lifetime methamphetamine and alcohol use disorder on health-related quality of life among people living with HIV (PWH); to determine if individual socioeconomic status (SES) may partly explain any associations. Methods: Participants included 276 PWH (Age: M = 43.7, SD = 10.6; Education: M = 13.6, SD = 2.6; 90% male) from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study living in Southern California between 2003 and 2020. Participants completed the Composite International Diagnostic Interview for DSM-IV and The HIV Medical Outcomes Survey (MOS-HIV). Individuals were grouped by whether they met DSM-IV criteria for lifetime alcohol and/or methamphetamine abuse and/or dependence (i.e., Alc-/Meth- [n = 76], Alc+/Meth- [n = 76], Alc-/Meth+ [n = 32], Alc+/Meth+ [n = 94]). MOS-HIV Physical and Mental Health summary scores (i.e., PHS, MHS) were the primary outcome variables, where higher scores indicated better perceived health. The occupational factor of the Hollingshead Two Factor Index was a proxy for individual SES (1 to 6, unskilled to professional work). Multivariable regression models examined the relationship between lifetime Alc/Meth use disorder and PHS and MHS, and whether occupational level at least partly explained this relationship. Results: Alc/Meth groups differed across age, education, AIDS status, estimated duration of HIV infection, and lifetime major depressive disorder diagnosis (ps < 0.05). Alc-/Meth- had higher occupational level than Alc+/Meth+ (p = 0.02), higher PHS than Alc+/Meth- (p = 0.01), and higher MHS than Alc+/Meth- (p = 0.03) and Alc-/Meth+ (p = 0.04). Neighborhood SES did not differ by group (p = 0.54). Controlling for group differences, the combination of both drug disorders was significantly associated with MHS (b = 5.9; 95%CI = 0.3, 11.5; p = 0.04), but not PHS (p = 0.11). Meth+ diagnosis worsened MHS for the ALC- group, but improved MHS for the ALC+ group. Accounting for occupation level (p = 0.07) resulted in a non-significant interaction between lifetime Alc/Meth disorder on MHS (b = 5.1; 95%CI = 0.3, 11.5; p = 0.07). Conclusions: PWH who reported combined lifetime alcohol and lifetime methamphetamine use had better mental health quality of life scores than those with methamphetamine only, suggesting that the two substances might offset the deleterious effects of one alone. Occupational level may partially account for this relationship. Further investigation into the impact of socioeconomic factors on impact health-related quality of life among lifetime polysubstance users living with HIV is warranted.

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