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Drug Use Among Adolescents and Young Adults with Unsuppressed HIV Who Use Alcohol: Identifying Patterns of Comorbid Drug Use and Associations with Mental Health

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Abstract

Youth living with HIV (YLWH; aged 16–24) are at elevated risk of alcohol and drug use. Studies in older populations have identified patterns or profiles of multiple substance use differentially associated with mental health and anti-retroviral therapy (ART) adherence. No studies of YLWH have yet examined such patterns. A sample of 179 YLWH, reporting ART non-adherence and alcohol use, were recruited at five Adolescent Trials Network clinics in urban areas of the US between November 2014 and August 2017. Participants completed the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) to assess substance use involvement scores, and the Brief Symptom Inventory. Latent Profile Analysis identified three substance use patterns: minimal illicit drug use (15.1%), cannabis only (56.4%), and global polysubstance use (28.5%). Global polysubstance users experienced more mental health problems compared to the minimal illicit drug use group. The co-occurrence of drug use with alcohol was common among these YLWH—all of whom reported ART adherence problems—indicating the importance of interventions capable of addressing multiple substance use rather than alcohol alone.

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Acknowledgements

Collection and analyses of these data were supported by a National Institute on Drug Abuse Grant (R01 AA022891; PI: Naar). The funding source had no involvement in study design or in the writing of this article. The authors acknowledge the contributions of the Healthy Choices Project Team, as well as staff, recruiters, interns and our participants who volunteered their time.

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Authors and Affiliations

  1. Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave., Room 611 Hunter North, New York, NY, 10065, USA

    Tyrel J. Starks & Brett M. Millar

  2. Health Psychology and Clinical Science Doctoral Program, Graduate Center of CUNY, New York, NY, USA

    Tyrel J. Starks

  3. Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA

    Karen Kolmodin MacDonell & Veronica Dinaj-Koci

  4. Center for Translational Behavioral Research, Florida State University College of Medicine, Tallahassee, FL, USA

    Amy L. Pennar & Sylvie Naar

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  1. Tyrel J. Starks
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Correspondence to Tyrel J. Starks.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Starks, T.J., MacDonell, K.K., Pennar, A.L. et al. Drug Use Among Adolescents and Young Adults with Unsuppressed HIV Who Use Alcohol: Identifying Patterns of Comorbid Drug Use and Associations with Mental Health. AIDS Behav 24, 2975–2983 (2020). https://doi.org/10.1007/s10461-020-02848-8

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