Impact of mood/anxiety and substance use disorders on the HIV continuum of care and healthcare utilization of people living with HIV
department or school: Medicine, Faculty of
department or school: Medicine, Department of
data provider: DSpace
degree campus: UBCV
creator: Shayegi-Nik, Sara
issued: 2024-07-12T15:26:03Z
issued: 2024
related degree: Master of Science - MSc
degree grantor: University of British Columbia
description: Introduction: Substance use disorder (SUD), mood, and anxiety disorders disproportionately affect people living with HIV (PLWH). However, comprehensive research on the effects of these disorders on HIV care engagement and healthcare utilization of PLWH is lacking. This thesis aimed to assess the impact of the syndemic between SUD and mood/anxiety disorders on the HIV continuum of care for PLWH in British Columbia (BC), Canada, and identify the stage with the highest attrition in the continuum. Additionally, this thesis intended to examine the effects of SUD, mood/anxiety disorders, and disengagement from HIV care (at the stage with the highest attrition) on healthcare utilization of PLWH. Methods: This retrospective population-based cohort study utilized data from the Comparative Outcomes And Service Utilization Trends (COAST) study that contains data on all diagnosed PLWH in BC. Eligible individuals were ≥19 years of age and were followed during 2001-2019. First, I identified the stage with the highest attrition in the HIV continuum of care. Using statistical models, I measured the associations between SUD and mood/anxiety disorders and the achievement of each stage of the continuum. I then measured the effects of these disorders and disengagement from HIV care (at the stage with the highest attrition) on counts of physician visits, hospitalization, and length of stay (LOS). Results: The stage of sustained viral suppression exhibited the highest attrition. SUD was associated with incomplete antiretroviral therapy adherence (adjusted Odds Ratio (aOR) 0.47, 95% CI: 0.42-0.53) and unsustained suppression (aOR 0.58, 95% CI: 0.53-0.63). Mood/anxiety disorders were also associated with incomplete adherence (aOR 0.78, 95% CI: 0.71-0.87) and unsustained suppression (aOR 0.82, 95% CI: 0.77-0.88). Having both disorders was associated with over four times more acute care hospitalizations, three times longer length of stay and almost twice the physician visits. Unsustained sup…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/88629
note: Impact of Mood/Anxiety and Substance Use Disorders on the HIV Continuum of Care and Healthcare Utilization of People Living With HIV by Sara Shayegi-Nik B.Sc., Simon Fraser University, 2020 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Experimental Medicine) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) July 2024 © Sara Shayegi-Nik, 2024 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the thesis entitled: Impact of Mood/Anxiety and Substance Use Disorders on the HIV Continuum of Care and Healthcare Utilization of People Living With HIV submitted by Sara Shayegi-Nik in partial fulfilment of the requirements for the degree of Master of Science in Experimental Medicine Examining Committee: Viviane Dias Lima, Associate Professor, Medicine, UBC Supervisor Robert S. Hogg, Professor, Health Sciences, Simon Fraser University Supervisory Committee Member William G. Honer, Professor, Psychiatry, UBC Supervisory Committee Member Melanie Murray, Associate Professor, Medicine, UBC Additional Examiner iii Abstract Introduction: Substance use disorder (SUD), mood, and anxiety disorders disproportionately affect people living with HIV (PLWH). However, comprehensive research on the effects of these disorders on HIV care engagement and healthcare utilization of PLWH is lacking. This thesis aimed to assess the impact of the syndemic between SUD and mood/anxiety disorders on the HIV continuum of care for PLWH in British Columbia (BC), Canada, and identify the stage with the highest attrition in the continuum. Additionally, this thesis intended to examine the effects of SUD, mood/anxiety disorders, and disengagement from HIV care (at the stage with the highest attrition) on healthcare utilization of PLWH. Methods: This retrospective population-based cohort study utilized data from the Compara…
has type: Thesis/Dissertation
date issued: 2024-11
is shown at: 10.14288/1.0444150
language: eng
degree discipline: Experimental Medicine
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Lima, Viviane Dias
type: Text
identifier URI: http://hdl.handle.net/2429/88629