Background
Drug use is more prevalent among people with HIV and can worsen HIV-related outcomes. Screening and discussions about drug use with a healthcare provider (HCP) have been found to be associated with higher perceived need and receipt of drug treatment. We explored differences in past-year drug use, screening, and discussion with a HCP among younger and older adults with and without HIV.
Methods
We used nationally representative data from the 2021-2022 National Survey on Drug Use and Health among the civilian, non-institutionalized population in the US. Past-year drug use (marijuana, cocaine, crack, heroin, inhalants, hallucinogens, and methamphetamine), screening (HCP asked about drug use), and discussion about drug use with a HCP among younger adults (18-49) and older adults (50+) with and without HIV were estimated using weighted frequencies and percentages and compared using Rao-Scott chi-squared tests.
Results
Among younger adults with HIV (n=440,990) versus without HIV (n=35,510,625), the prevalence of past-year marijuana (53% vs 31%, p=0.001), cocaine (8% vs 3%, p=0.008), heroin (3% vs 1%, p=0.028), inhalant (14% vs 1%, p<0.001), and methamphetamine (14% vs 2%, p<0.001) use was significantly higher. Among older adults with HIV (n=492,809) versus without HIV (n=72,272,744), the prevalence of past-year marijuana (54% vs 11%, p<0.001), crack (3% vs 0.4%, p=0.020), heroin (3% vs 0.3%, p=0.008), inhalant (8% vs 0.1%, p<0.001), hallucinogen (4% vs 0.4%, p=0.001), and methamphetamine (15% vs 1%, p<0.001) use was significantly higher. In both age groups, past-year drug use screening was not significantly different among adults with HIV versus without HIV who reported past-year drug use (18-49: 72% vs 73%, p=0.949; 50+: 70% vs 56%, p=0.224). Similarly, discussion with a HCP about drug use among those with and without HIV was not significantly different across age (18-49: 33% vs 29%, p=0.630; 50+: 26% vs 22%, p=0.716).
Conclusions
Although past-year drug use was significantly higher in both younger and older adults with HIV compared to those without HIV, there was no difference in the prevalence of drug use screening or discussion with a HCP, suggesting room for improvement for HCP engagement about drug use with patients with HIV. Efforts to maximize opportunities for screening and discussion are needed to decrease drug use and prevent related negative health outcomes among people with HIV.
Table or Figure
