Influence of Substance Use Disorders on 2-Year HIV Care Retention in the United States

Academic Article


  • Substance use disorders (SUDs) are thought to predict care discontinuity, though magnitude and substance-specific variance of effects are unclear. This report of analytic work undertaken with a multi-regional American cohort of 9153 care enrollees addresses these gaps. Care retention was computed from 24-month post-linkage clinic visit documentation, with SUD cases identified from patient-report screening instruments. Two generalized estimating equations tested binary and hierarchial SUD predictors of retention, and potential effect modification by patient age-group, sex, and care site. Findings demonstrate: (1) detrimental SUD effect, equivalent to a nine percentage-point decrease in retention, with independent effects of age-group and care site; (2) substance-specific effect of marijuana UD associated with lower retention; and (3) age-modification of each effect on care discontinuity, with SUDs serving as a risk factor among 18–29 year-olds and protective factor among 60+ year-olds. Collective findings document patient attributes as influences that place particular subgroups at-risk to discontinue care.
  • Published In

  • AIDS and Behavior  Journal
  • Digital Object Identifier (doi)

    Pubmed Id

  • 24729041
  • Author List

  • Hartzler B; Dombrowski JC; Williams JR; Crane HM; Eron JJ; Geng EH; Mathews C; Mayer KH; Moore RD; Mugavero MJ
  • Start Page

  • 742
  • End Page

  • 751
  • Volume

  • 22
  • Issue

  • 3