Understanding Substance Reuse Among Sexual and Gender Minority Individuals With HIV

Abstract

Research shows that people living with HIV (PLWH) who are of sexual and gender minority (SGM) status experience higher rates of substance use disorders (SUDs) compared to heterosexual, cisgender individuals; however, there is a lack of research examining substance use treatment outcomes among individuals with multiple minority statuses. This study explored a multiple minority PLWH population to examine how SGM status influences time to substance reuse, frequency of use, and substance use related problems. Participants included 56 PLWH with problematic substance use who were enrolled in an abstinence-focused inpatient substance use treatment center in Washington, DC. Participants completed 16 sessions and were followed over 12 months post treatment. A discrete time to event logit model was used to examine whether SGM status moderated time to reuse. A total of n=21 individuals self-identified as SGM and n=35 identified as non-SGM. Approximately 64% of the sample returned to substance use at least once over the 12 months. At the end of 12-month follow-up, the survival rate was 20.5% of the overall sample. In the non-SGM group, the survival rate was 37.6% compared with 4.8% in the SGM group. The overall time to event model was significant ( λ2= 25.46, p <.001). The odds of reuse for those with SGM status increased by 1.88 [95% CI: .84, 4.19], suggesting likely need for SGM specialized care and those who identify with multiple minority statuses. Despite strengths of the longitudinal design, future work must replicate these findings in a larger sample.

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