{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:22:25Z","timestamp":1780730545235,"version":"3.54.1"},"reference-count":32,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIH","award":["AI 027757"],"award-info":[{"award-number":["AI 027757"]}]},{"name":"NIH","award":["R25 DA050985"],"award-info":[{"award-number":["R25 DA050985"]}]},{"name":"NIH","award":["P30 MH123248"],"award-info":[{"award-number":["P30 MH123248"]}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["AI 027757"],"award-info":[{"award-number":["AI 027757"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R25 DA050985"],"award-info":[{"award-number":["R25 DA050985"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["P30 MH123248"],"award-info":[{"award-number":["P30 MH123248"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"NIMH","doi-asserted-by":"publisher","award":["AI 027757"],"award-info":[{"award-number":["AI 027757"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"NIMH","doi-asserted-by":"publisher","award":["R25 DA050985"],"award-info":[{"award-number":["R25 DA050985"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"NIMH","doi-asserted-by":"publisher","award":["P30 MH123248"],"award-info":[{"award-number":["P30 MH123248"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["COVID"],"abstract":"<jats:p>Background. People living with HIV (PWH) frequently have co-morbid substance use disorders that may have been impacted by the COVID-19 pandemic. This study examined associations between COVID-related stress and increased substance use among PWH in Washington State. Methods. Between August 2020 and March 2021, we conducted an online survey of 397 PWH in western Washington. Logistic regression was used to analyze associations between a COVID-19 stress score and four self-reported outcomes: increased alcohol use, increased cigarette smoking, increased marijuana use, and increased use of illicit substances. Results. Thirty-five (38.0%) of 92 participants who smoked, 61 (23.4%) of 261 participants who used alcohol, 15 (14.6%) of 103 participants who used marijuana, and 35 (33.0%) of 102 participants who used illicit substances reported increased use of these substances. Higher COVID-19 stress scores were associated with higher odds of increased cigarette smoking (adjusted odds ratio [aOR] = 1.15, 95% confidence interval [CI]: 1.04\u20131.27), even after adjustment for anxiety and depressive symptoms (aOR 1.14, 95%CI: 1.03\u20131.27). COVID-19 stress was not associated with an increased use of alcohol, marijuana, or illicit substances. Conclusions. COVID-19-related stress was associated with self-reported increased cigarette smoking among PWH in western Washington during the pandemic.<\/jats:p>","DOI":"10.3390\/covid4100112","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T08:09:52Z","timestamp":1727683792000},"page":"1617-1630","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["COVID-19 Stress Is Associated with Increased Smoking among People with HIV in Western Washington: A Cross-Sectional Survey"],"prefix":"10.3390","volume":"4","author":[{"given":"Anh Tuyet","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Santa Clara Valley Medical Center, San Jose, CA 95128, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Slaughter","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Smith","sequence":"additional","affiliation":[{"name":"Center on Gender Equity and Health, University of California, San Diego, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7786-0194","authenticated-orcid":false,"given":"David A.","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brigham & Women\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3123-2328","authenticated-orcid":false,"given":"Liying","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Nursing, Florida State University, Tallahassee, FL 32306, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8711-1576","authenticated-orcid":false,"given":"Jane M.","family":"Simoni","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith I.","family":"Tsui","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7847-8686","authenticated-orcid":false,"given":"Susan M.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, WA 98195, USA"},{"name":"Department of Global Health, University of Washington, Seattle, WA 98195, USA"},{"name":"Department of Medicine, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"ref_1","unstructured":"CDC (2023, July 25). Behavioral and Clinical Characteristics of Persons with Diagnosed HIV Infection\u2014Medical Monitoring Project, United States, 2019 Cycle (June 2019\u2013May 2020). HIV Surveillance Special Report 28, Available online: https:\/\/stacks.cdc.gov\/view\/cdc\/110355."},{"key":"ref_2","unstructured":"NIDA (2023, July 25). Part 3: The Connection between Substance Use Disorders and HIV, Available online: https:\/\/nida.nih.gov\/publications\/research-reports\/common-comorbidities-substance-use-disorders\/part-3-connection-between-substance-use-disorders-hiv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1089\/apc.2010.0139","article-title":"Mortality after diagnosis of psychiatric disorders and co-occurring substance use disorders among HIV-infected patients","volume":"24","author":"DeLorenze","year":"2010","journal-title":"AIDS Patient Care STDS"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/j.1530-0277.2010.01335.x","article-title":"Excess mortality among HIV-infected patients diagnosed with substance use dependence or abuse receiving care in a fully integrated medical care program","volume":"35","author":"DeLorenze","year":"2011","journal-title":"Alcohol Clin. Exp. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.2105\/AJPH.2012.301162","article-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","volume":"103","author":"Mimiaga","year":"2013","journal-title":"Am. J. Public Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s11606-002-0044-3","article-title":"Impact of active drug use on antiretroviral therapy adherence and viral suppression in HIV-infected drug users","volume":"17","author":"Arnsten","year":"2002","journal-title":"J. Gen. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1097\/QAD.0000000000001830","article-title":"Psychoactive substances, alcohol and tobacco consumption in HIV-infected outpatients","volume":"32","author":"Jacquet","year":"2018","journal-title":"AIDS"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1080\/09540121.2010.525617","article-title":"Association of ongoing drug and alcohol use with non-adherence to antiretroviral therapy and higher risk of AIDS and death: Results from ACTG 362","volume":"23","author":"Cohn","year":"2011","journal-title":"AIDS Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1093\/cid\/ciw416","article-title":"Impact of opioid substitution therapy on antiretroviral therapy outcomes: A systematic review and meta-analysis","volume":"63","author":"Low","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: Rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S., and Ho, R.C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17051729"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1080\/02791072.2017.1397304","article-title":"Understanding Postdisaster Substance Use and Psychological Distress Using Concepts from the Self-Medication Hypothesis and Social Cognitive Theory","volume":"50","author":"Alexander","year":"2018","journal-title":"J. Psychoact. Drugs"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1080\/09540121.2024.2341220","article-title":"Impact of the COVID-19 pandemic on mental health and viral suppression among persons living with HIV in western Washington","volume":"36","author":"Wang","year":"2024","journal-title":"AIDS Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1007\/s10461-024-04273-7","article-title":"Impact of the COVID-19 pandemic on persons living with HIV in western Washington: Examining lived experiences of social distancing stress, personal buffers, and mental health","volume":"28","author":"Smith","year":"2024","journal-title":"AIDS Behav."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"335","author":"Altman","year":"2007","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"102232","DOI":"10.1016\/j.janxdis.2020.102232","article-title":"Development and initial validation of the COVID Stress Scales","volume":"72","author":"Taylor","year":"2020","journal-title":"J. Anxiety Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1001\/jama.2020.5460","article-title":"Governmental public health powers during the COVID-19 pandemic: Stay-at-home orders, business closures, and travel restrictions","volume":"323","author":"Gostin","year":"2020","journal-title":"JAMA"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"101375","DOI":"10.1016\/j.eclinm.2022.101375","article-title":"Tobacco smoking changes during the first pre-vaccination phases of the COVID-19 pandemic: A systematic review and meta-analysis","volume":"47","author":"Sarich","year":"2022","journal-title":"eClinicalMedicine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.1007\/s10461-022-03638-0","article-title":"Psychological and emotional impact of COVID-19 pandemic on people living with chronic disease: HIV and cancer","volume":"26","author":"Fornari","year":"2022","journal-title":"AIDS Behav."},{"key":"ref_22","first-page":"19","article-title":"Anxiety and substance use disorders: A review","volume":"25","author":"Smith","year":"2008","journal-title":"Psychiat. Times"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101313","DOI":"10.1016\/j.eujim.2021.101313","article-title":"Association of smoking history with severe and critical outcomes in COVID-19 patients: A systematic review and meta-analysis","volume":"43","author":"Zhang","year":"2021","journal-title":"Eur. J. Integr. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/COH.0000000000000791","article-title":"The severity of COVID-19 across the spectrum of HIV","volume":"18","author":"Miller","year":"2023","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"106527","DOI":"10.1016\/j.addbeh.2020.106527","article-title":"Changes in alcohol use as a function of psychological distress and social support following COVID-19 related University closings","volume":"110","author":"Lechner","year":"2020","journal-title":"Addict. Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103053","DOI":"10.1016\/j.drugpo.2020.103053","article-title":"Medication and substance use increases among people using cannabis medically during the COVID-19 pandemic","volume":"92","author":"Boehnke","year":"2021","journal-title":"Int. J. Drug Policy"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1097\/QAD.0000000000002227","article-title":"Mental health and HIV\/AIDS: The need for an integrated response","volume":"33","author":"Remien","year":"2019","journal-title":"AIDS"},{"key":"ref_28","unstructured":"(2023, July 25). Director-General\u2019s Opening Remarks at the Media Briefing on COVID-19-29 June 2020. Available online: https:\/\/www-who-int.offcampus.lib.washington.edu\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---29-june-2020."},{"key":"ref_29","unstructured":"CDC (2023, July 25). CDC Museum COVID-19 Timeline, Available online: https:\/\/www.cdc.gov\/museum\/timeline\/covid19.html."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1056\/NEJMp2008017","article-title":"Mental health and the COVID-19 pandemic","volume":"383","author":"Pfefferbaum","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1159\/000351827","article-title":"Application of audio computer-assisted self-interviews to collect self-reported health data: An overview","volume":"47","author":"Brown","year":"2013","journal-title":"Caries Res."},{"key":"ref_32","unstructured":"Infectious Disease Assessment Unit, Washington State Department of Health (2023, July 25). Washington State HIV Surveillance Report, 2020 Edition, Available online: https:\/\/doh.wa.gov\/sites\/default\/files\/legacy\/Documents\/Pubs\/\/150-030-WAHIVSurveillanceReport2020.pdf."}],"container-title":["COVID"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-8112\/4\/10\/112\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:07:23Z","timestamp":1760112443000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-8112\/4\/10\/112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,30]]},"references-count":32,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["covid4100112"],"URL":"https:\/\/doi.org\/10.3390\/covid4100112","relation":{},"ISSN":["2673-8112"],"issn-type":[{"value":"2673-8112","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,30]]}}}