{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:38:06Z","timestamp":1789983486420,"version":"4.0.1"},"reference-count":66,"publisher":"American Public Health Association","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:p> Objectives. The purpose of this study was to better understand substance use behaviors and deleterious health consequences among individuals with HIV. <\/jats:p><jats:p> Methods. We examined a multicenter cohort of HIV-infected patients (n\u2009=\u20093413) receiving care in 4 US cities (Seattle, Birmingham, San Diego, Boston) between December 2005 and April 2010 in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS). We used generalized estimating equations to model specific substance use outcomes. <\/jats:p><jats:p> Results. Overall, 24% of patients reported recent use of marijuana; 9% reported amphetamine use, 9% reported crack\u2013cocaine use, 2% reported opiate use, 3.8% reported injection drug use, and 10.3% reported polydrug use. In adjusted multivariable models, those who reported unprotected anal sex had higher odds of marijuana, amphetamine, injection drug, and polydrug use. An increased number of distinct vaginal sexual partners was associated with polydrug and crack\u2013cocaine use. Nonadherence to antiretroviral therapy was associated with the use of all substances other than marijuana. <\/jats:p><jats:p> Conclusions. The co-occurrence of substance use, unprotected intercourse, and medication nonadherence could attenuate the public health benefits of test, treat, and link to care strategies. Prevention programs are needed that address these coprevalent conditions. <\/jats:p>","DOI":"10.2105\/ajph.2012.301162","type":"journal-article","created":{"date-parts":[[2013,6,13]],"date-time":"2013-06-13T19:59:17Z","timestamp":1371153557000},"page":"1457-1467","source":"Crossref","is-referenced-by-count":196,"title":["Substance Use Among HIV-Infected Patients Engaged in Primary Care in the United States: Findings From the Centers for AIDS Research Network of Integrated Clinical Systems Cohort"],"prefix":"10.2105","volume":"103","author":[{"given":"Matthew J.","family":"Mimiaga","sequence":"first","affiliation":[{"name":"Matthew J. Mimiaga, Sari L. Reisner, and Steven A. Safren are with the Department of Psychiatry, Harvard Medical School\/Massachusetts General Hospital, Boston. Chris Grasso and Kenneth H. Mayer are with the Fenway Institute, Fenway Health, Boston. Heidi M. Crane and Mari M. Kitahata are with the Division of Infectious Diseases, University of Washington School of Medicine, Seattle. Joseph E. Schumacher is with the Division of Preventive Medicine, University of Alabama at Birmingham. W. Christopher Mathews..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari L.","family":"Reisner","sequence":"additional","affiliation":[{"name":"Matthew J. Mimiaga, Sari L. Reisner, and Steven A. Safren are with the Department of Psychiatry, Harvard Medical School\/Massachusetts General Hospital, Boston. Chris Grasso and Kenneth H. Mayer are with the Fenway Institute, Fenway Health, Boston. Heidi M. Crane and Mari M. Kitahata are with the Division of Infectious Diseases, University of Washington School of Medicine, Seattle. Joseph E. Schumacher is with the Division of Preventive Medicine, University of Alabama at Birmingham. W. Christopher Mathews..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Grasso","sequence":"additional","affiliation":[{"name":"Matthew J. Mimiaga, Sari L. Reisner, and Steven A. Safren are with the Department of Psychiatry, Harvard Medical School\/Massachusetts General Hospital, Boston. Chris Grasso and Kenneth H. Mayer are with the Fenway Institute, Fenway Health, Boston. Heidi M. Crane and Mari M. Kitahata are with the Division of Infectious Diseases, University of Washington School of Medicine, Seattle. Joseph E. Schumacher is with the Division of Preventive Medicine, University of Alabama at Birmingham. W. Christopher Mathews..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi M.","family":"Crane","sequence":"additional","affiliation":[{"name":"Matthew J. Mimiaga, Sari L. Reisner, and Steven A. Safren are with the Department of Psychiatry, Harvard Medical School\/Massachusetts General Hospital, Boston. Chris Grasso and Kenneth H. Mayer are with the Fenway Institute, Fenway Health, Boston. Heidi M. Crane and Mari M. Kitahata are with the Division of Infectious Diseases, University of Washington School of Medicine, Seattle. Joseph E. Schumacher is with the Division of Preventive Medicine, University of Alabama at Birmingham. W. Christopher Mathews..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Safren","sequence":"additional","affiliation":[{"name":"Matthew J. Mimiaga, Sari L. Reisner, and Steven A. Safren are with the Department of Psychiatry, Harvard Medical School\/Massachusetts General Hospital, Boston. Chris Grasso and Kenneth H. Mayer are with the Fenway Institute, Fenway Health, Boston. Heidi M. Crane and Mari M. Kitahata are with the Division of Infectious Diseases, University of Washington School of Medicine, Seattle. Joseph E. Schumacher is with the Division of Preventive Medicine, University of Alabama at Birmingham. W. 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