ArticleOpen forum infectious diseases2019
Association of Syndemic Unhealthy Alcohol Use, Cigarette Use, and Depression With All-Cause Mortality Among Adults Living With and Without HIV Infection: Veterans Aging Cohort Study.
Article in Open forum infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 31 citations in OpenAlex.
- A Randomized Feasibility/Acceptability Trial of Acceptance and Commitment Therapy for People with HIV Who Drink at Unhealthy Levels.AIDS and behavior · 2026Trial
- Mental health and substance use screening in HIV primary care before and during the early COVID-19 pandemic.BMC health services research · 2023Trial
- The longitudinal association between depression, anxiety symptoms and HIV outcomes, and the modifying effect of alcohol dependence among ART clients with hazardous alcohol use in Vietnam.Journal of the International AIDS Society · 2021Trial
- Alcohol Use Disorder and Depression Among Community-Based Clinic Patients Before and During the COVID-19 Public Health Emergency, by Smoking Status.AJPM focus · 2026Article
- Gender, mental health symptoms, loss to clinic, and viral non-suppression 6 months after HIV care initiation among a cohort of people with HIV in Cameroon.BMC public health · 2025Article
- Acceptance and commitment therapy for people with HIV who drink at unhealthy levels: Protocol for the ACCEPT randomized controlled trial.Contemporary clinical trials · 2025Article
- Physical Activity, Cigarette Smoking, and Depression Among People with HIV.AIDS and behavior · 2025Article
- Impact of syndemic heavy drinking, smoking, and depression on mortality among MSM with and without HIV: A longitudinal study.Drug and alcohol dependence · 2025Article
- Article
- Design and rationale for a randomized clinical trial testing the efficacy of a lifestyle physical activity intervention for people with HIV and engaged in unhealthy drinking.Contemporary clinical trials · 2024Article
- Psychosocial Syndemic Classes and Longitudinal Transition Patterns Among Sexual Minority men Living with or Without HIV in the Multicenter AIDS Cohort Study (MACS).AIDS and behavior · 2023Article
- HIV and an Ageing Population-What Are the Medical, Psychosocial, and Palliative Care Challenges in Healthcare Provisions.Microorganisms · 2023Review
- Syndemic trajectories of heavy drinking, smoking, and depressive symptoms are associated with mortality in women living with HIV in the United States from 1994 to 2017.Drug and alcohol dependence · 2023Article
- The use of biomarkers to guide precision treatment for tobacco use.Addiction neuroscience · 2023Article
- Treatment Regimens and Care Models for Older Patients Living with HIV: Are We Doing Enough?HIV/AIDS (Auckland, N.Z.) · 2023Review
- Association of Syndemic Unhealthy Alcohol Use, Smoking, and Depressive Symptoms on Incident Cardiovascular Disease among Veterans With and Without HIV-Infection.AIDS and behavior · 2021Observational
- National Estimates of Prevalence, Time-Trend, and Correlates of Smoking in US People Living with HIV (NHANES 1999-2016).Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2021Article
- Contribution of Behavioral Health Factors to Non-AIDS-Related Comorbidities: an Updated Review.Current HIV/AIDS reports · 2020Review
- Negative Lifestyle Factors Specific to Aging Persons Living with HIV and Multimorbidity.Journal of the International Association of Providers of AIDS CareReview
- Insights Provided by Depression Screening Regarding Pain, Anxiety, and Substance use in a Veteran Population.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
18 authors at 13 institutions in 2 countries.
Funding
Abstract
backgroundThe prevalence and risk of concurrent unhealthy drinking, cigarette use, and depression on mortality among persons living with HIV (PLWH) is unclear. This study applied a syndemic framework to assess whether these co-occurring conditions increase mortality and whether such risk is differential by HIV status.
methodsWe evaluated 6721 participants (49.8% PLWH) without baseline cancer from the Veterans Aging Cohort Study, a prospective, observational cohort of PLWH and matched uninfected veterans enrolled in 2002 and followed through 2015. Multivariable Cox proportional hazards regressions estimated risk of a syndemic score (number of conditions: that is, unhealthy drinking, cigarette use, and depressive symptoms) on all-cause mortality by HIV status, adjusting for demographic, health status, and HIV-related factors.
resultsFewer than 10% of participants had no conditions; 25.6% had 1, 51.0% had 2, and 15.0% had all 3. There were 1747 deaths (61.9% PLWH) during the median follow-up (11.4 years). Overall, age-adjusted mortality rates/1000 person-years increased with a greater number of conditions: (0: 12.0; 1: 21.2; 2: 30.4; 3: 36.3). For 3 conditions, the adjusted hazard ratio of mortality was 36% higher among PLWH compared with uninfected participants with 3 conditions (95% confidence interval, 1.07-1.72;
conclusionsSyndemic unhealthy drinking, cigarette use, and depression are common and are associated with higher mortality risk among PLWH, underscoring the need to screen for and treat these conditions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.