ArticleAntiviral therapy2019
Substance use patterns and HIV-1 RNA viral load rebound among HIV-positive illicit drug users in a Canadian setting.
Article in Antiviral therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- The impact of multiple-behavior HIV interventions as a function of regional disadvantages: An analysis of syndemics.Journal of consulting and clinical psychology · 2023Pooled it
- Factors Associated With Viral Suppression Among People Living With HIV (PLWH) in Kermanshah, Iran: A Retrospective Cohort Study.Health science reports · 2026Article
- Associations between cannabis use, cannabis use motivations and past year polysubstance use among people living with HIV in Florida.AIDS care · 2026Article
- Prevalence, patterns, and associated factors of psychoactive substance use among people living with HIV in Lomé, Togo : a cross-sectional study.BMC public health · 2026Article
- Antiretroviral utilization and adherence before vs. after expansion of a provincial drug insurance policy.AIDS (London, England) · 2026Article
- Treatment of Advanced HIV in the Modern Era.Drugs · 2025Review
- Longitudinal patterns and predictors of opioid and stimulant use initiation and cessation among female sex workers living with HIV in South Africa.Drug and alcohol dependence · 2025Article
- Mobile Health Tool to Capture Social Determinants of Health and Their Impact on HIV Treatment Outcomes Among People Who Use Drugs: Pilot Feasibility Study.JMIR formative research · 2025Article
- Article
- Prevalence and factors associated with HIV viral rebound in individuals on ART: A systematic review study.Journal of public health in Africa · 2025Review
- Prevalence and Correlates of Heavy Alcohol use among People Living with HIV who use Unregulated Drugs in Vancouver, Canada.AIDS and behavior · 2024Article
- Cocaine regulates antiretroviral therapy CNS access through pregnane-x receptor-mediated drug transporter and metabolizing enzyme modulation at the blood brain barrier.Fluids and barriers of the CNS · 2024Article
- Evaluation of Treatment Outcomes Among Individuals on Highly Active Antiretroviral Therapy in KwaZulu-Natal, South Africa.AIDS research and treatment · 2024Article
- Overamped: Stimulant Use and HIV Pathogenesis.Current HIV/AIDS reports · 2023Review
- Polysubstance Use Patterns Associated With HIV Disease Severity Among Those With Substance Use Disorders: A Latent Class Analysis.Journal of studies on alcohol and drugs · 2023Article
- Crack cocaine use frequency is associated with HIV disease severity independent of antiretroviral therapy exposure: a prospective cohort study.AIDS and behavior · 2022Article
- Injection and Non-Injection Drug Use Among Adults with Diagnosed HIV in the United States, 2015-2018.AIDS and behavior · 2022Article
- Article
- Substance Use Predicts Sustained Viral Suppression in a Community Cohort of Sexual and Gender Minority Youth Living with HIV.AIDS and behavior · 2021Article
- Frequent Cannabis Use Is Negatively Associated with Frequency of Injection Drug Use Among People Who Inject Drugs in a Canadian Setting.Cannabis and cannabinoid research · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundActive illicit drug use can present a barrier to the medical management of HIV infection by complicating adherence to antiretroviral therapy (ART). Plasma HIV-1 RNA viral load (VL) rebound, defined as a period of detectable HIV VL following ART and VL suppression, can lead to the generation of viral resistance and potential treatment failure. We sought to investigate the contribution of substance use patterns on rates of VL rebound.
methodsWe used data from the ACCESS study, a long-running community-recruited prospective cohort of HIV-positive people who use illicit drugs in Vancouver, Canada, a setting of universal no-cost HIV treatment. We analysed time to VL rebound (that is, two consecutive observations ≥1,000 copies/ml) after ART initiation and sustained viral suppression (that is, two consecutive observations <50 copies/ml) using extended Cox regression models with a recurrent events framework.
resultsBetween May 1996 and November 2013, 564 ART-exposed participants achieved at least one instance of VL suppression and contributed 1,893.8 person-years of observation. Over follow-up, 198 (35.1%) participants experienced ≥ one instance of VL rebound. In adjusted analyses, VL rebound was associated with younger age (adjusted hazard ratio [AHR] =0.97, 95% CI: 0.95, 0.98), heroin injection (≥ daily versus < daily, AHR =1.52, 95% CI: 1.01, 2.30), crack use (≥ daily versus < daily, AHR = 1.73, 95% CI: 1.08, 1.92) and heavy alcohol use (≥ four versus < four drinks/day, AHR =1.97, 95% CI: 1.17, 3.31).
conclusionsThe present study suggests that in addition to heavy alcohol use, high-intensity illicit drug use, particularly ≥ daily heroin injection and ≥ daily crack smoking are risk factors for VL rebound. In addition to the impact of high-intensity drug use on health-care engagement and ART adherence, some evidence exists on the direct impact of psychoactive substances on ART metabolism and the natural progression of HIV disease. At-risk individuals should be provided additional supports to preserve virological control and maintain the benefits of ART.
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