Patterns of Substance Use and Arrest Histories Among Hospitalized HIV Drug Users: A Latent Class Analysis
Using baseline data from the NIDA Clinical Trials Network 0049 study (Project HOPE), we performed latent class analyses (LCA) to identify discrete classes, or clusters, of people living with HIV (PLWH) based on their past year substance use behaviors and lifetime arrest history. We also performed multinomial logistic regressions to identify key characteristics associated with class membership. We identified 5 classes of substance users (minimal drug users, cocaine users, substantial cocaine/hazardous alcohol users, problem polysubstance users, substantial cocaine/heroin users) and 3 classes of arrest history (minimal arrests, non-drug arrests, drug-related arrests). While several demographic variables such as age and being Black or Hispanic were associated with class membership for some of the latent classes, participation in substance use treatment was the only covariate that was significantly associated with membership in all classes in both substance use and arrest history LCA models. Our analyses reveal complex patterns of behaviors among substance using PLWH and suggest that HIV intervention strategies may need to take into consideration such nuanced differences to better inform future studies and program implementation.
KeywordsHIV/AIDS Substance abuse Arrest Criminal justice Latent class analysis
The authors recognize the CTN-0049 staff for their dedication and we show gratitude to CTN-0049 collaborators, in particular the Public Health Trust/Jackson Health System, the Grady Health System, Johns Hopkins University, Boston Medical Center, Hahnemann University Hospital, Rush University Medical Center, Parkland Health and Human Services, University of Pittsburgh, University of California Los Angeles, University of Alabama at Birmingham, and Saint Luke’s Roosevelt Hospital, for their support on this project. CTN-0049 (Project HOPE) was funded by the NIH/NIDA National Drug Abuse Treatment Clinical Trials Network (U10-DA13720, PIs: Szapocznik, Metsch). Additionally, Ms. Shiu-Yee is supported by the NIH/NIDA HIV and Substance Abuse in the Criminal Justice System training program (T32-DA037801, PIs: El-Bassel, Metsch) and Dr. Frimpong is supported in-part by the NIH/NIDA Mentoring Early-Career Scientists for Drug Abuse Research Careers program (R25-DA035163, PIs: Masson, Sorensen). All authors contributed to the preparation of this manuscript. KS-Y, AMB, and DJF jointly conceived this analysis. AMB and DJF designed the LCA models and conducted the analysis with input from KS-Y. LRM was one of the principal investigators and she oversaw the design and data collection of Project HOPE.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All study procedures involving human participants in CTN-0049 (Project HOPE) 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. All procedures received IRB approval from study sites.
Informed consent was obtained from all participants included in the study.
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