Resumen
Background: In Spain, drug use among people with HIV (PHIV) seems to be increasing. We analyse their profile and impact on quality of life (QoL) and health-related variables. Methods: 1401 PHIV participated in a cross-sectional survey conducted between November 2016 and April 2017. An on-line survey was designed that measured: demographics, health data, drug use, treatment adherence (CEAT-VIH) and QoL (WHOQoL-HIV-bref). Data were collected throughout 33 centers Spain. A two-stage cluster analysis to classify participants according to their demographic, drugs used and routes of consumption profile was conducted. Results: From the total sample 49.5% used drugs and 80.8% have used them prior to HIV diagnosis. Around 70% were men who have sex with men (MSM). Cannabis (73.8%), cocaine (53.9%) and poppers (45.4%) were the more prevalent drugs used. There were 6.8% who used injection route. Two big epidemiological profiles of participants were found. The first one was composed mainly for heterosexuals (HTX) who acquired HIV through injection route. The second one was composed mainly by MSM infected by sexual intercourse. HTX were older, had a lower socioeconomic status, lower level of education and more than double of years living with HIV than MSM (p<.0001). According to their profile of drug use both groups were divided in two clusters. Among HTX, Cluster1 (n=198) were mainly users of cannabis and 25% of them of powder cocaine. Most women were classified in it. Cluster2 (n=60) were mainly men who used traditional/marginal drugs and had the highest percentage of drug injectors (38%). Among MSM, Cluster3 (n=284) were mainly users of cannabis (63.7%), poppers (62.7%) and powder cocaine (54%), while Cluster4 (n=150) was characterized by the highest drugs polyconsumption (7.4±2.1; p<.0001), higher frequency of drug use (p<.0001) and 10% of them have used the injection route. They practice more chemsex and had more sexually transmitted infections (p<.05). Cluster2 showed the lowest level of ART adherence (77.3%; p<.05), followed by Cluster1 and Cluster4 (84.2% and 86.4%, p<.05). The lowest score in QoL was found in Cluster2 (56.7±16.9, p<.0001), followed by Cluster2 (63.9±14.7, p<.05) and it did not differ among the MSM clusters and no drug users (range from 70.6 to 73.9). Conclusions: This is the largest survey on prevalence of drug use in PHIV in Spain. Interventions to improve QoL should be address to HTX drug users (mainly users of marginal drugs) and also to MSM polyconsumers to prevent its possible deterioration in the future.
Autoría:
FUSTER RUIZ DE APODACA, María José;
CASTRO GRANELL, Vanessa;
LAGUÍA GONZÁLEZ, Ana;
TOLEDO PALLARÉS, Javier;
PASTOR, María;
FONT, R.;
FERRANDO, R.;
GALINDO PUERTO, María José;
JAEN, Àngels;
GRAEFENHAIN, R.;
CENOZ GOMIS, Santiago