Abstract

Objectives: People living with HIV (PWH) have seen reduction in HIV-associated morbidity and increase in near-normal life expectancy, yet unhealthy alcohol use poses substantial risks to older as well as younger adults. Further research regarding age-associated physical and mental health concerns among PWH who drink alcohol is needed to inform services, given the expanding age range of patients in care.

Methods: We compared age group differences (18–34, 35–44, 45–54, ≥55 years old) in two-year patient-reported outcomes and HIV viral control among PWH enrolled in a primary care-based behavioral alcohol intervention trial; with 90% follow up from baseline.

Results: Of 553 PWH, 50 (9%) were 18–34, 85 (15%) were 35–44, 197 (36%) were 45–54, and 221 (40%) were ≥55 years old. Most were men (97%) and White (64%). At two years, PWH ≥55 reported less substance use in the prior 30 days, fewer social contacts, and more pain; younger PWH had lower antiretroviral therapy (ART) adherence. In adjusted analyses, PWH ages 18–34 had higher odds of unhealthy alcohol use, tobacco, cannabis, or other substances compared to those ≥55; with higher odds of anxiety among PWH 35–44 compared with those ≥55; and physical quality of life was worse among those ≥55 compared with younger groups.

Conclusions: While older PWH report less substance use than younger PWH and have better ART adherence post-treatment, they are more likely to experience limited social support and worse physical quality of life. Findings can inform interventions to address varying needs of PWH across the lifespan.

摘要

目标： HIV 感染者 (PWH) 的 HIV 相关发病率有所降低，预期寿命接近正常水平有所增加，但不健康的饮酒对老年人和年轻人都构成了重大风险。鉴于接受护理的患者年龄范围不断扩大，需要进一步研究饮酒 PWH 中与年龄相关的身心健康问题，以便为服务提供信息。

方法：我们比较了参加基于初级保健的行为酒精干预试验的 PWH 的两年患者报告结果和 HIV 病毒控制的年龄组差异（18-34、35-44、45-54、≥55 岁） ; 90% 从基线跟进。

结果：在 553 名 PWH 中，50 名（9%）为 18-34 岁，85 名（15%）为 35-44 岁，197 名（36%）为 45-54 岁，221 名（40%）年龄≥55 岁。大多数是男性 (97%) 和白人 (64%)。两年后，PWH ≥ 55 报告前 30 天物质使用较少、社交接触较少和疼痛较多；年轻的 PWH 抗逆转录病毒疗法 (ART) 的依从性较低。在调整后的分析中，与≥55 岁的人群相比，18-34 岁的 PWH 有更高的不健康酒精使用、烟草、大麻或其他物质的几率；与 ≥55 岁的人相比，35-44 岁的 PWH 有更高的焦虑几率；与年轻人群相比，≥55 岁人群的身体质量更差。

结论：虽然年长的 PWH 比年轻的 PWH 报告物质使用更少，并且治疗后 ART 依从性更好，但他们更有可能经历有限的社会支持和更差的身体生活质量。调查结果可以为干预措施提供信息，以解决 PWH 在整个生命周期中的不同需求。