Patterns of Substance Use and Arrest Histories Among Hospitalized HIV Drug Users

• People living with HIV (PLWH) who use substances continue to have shorter life expectancies and worse health outcomes than PLWH who do not use substances.
• Another important contributor to factors that can affect the health of PLWH who use substances is these individuals’ frequent interactions with the criminal justice system.
• This analysis of baseline data from the NIDA Clinical Trials Network CTN-0049 study (Project HOPE) aimed to expand the current literature examining the complex relationships between PLWH’s substance use behaviors and criminal justice involvement to better inform future studies and improve program implementation.

Researchers performed latent class analyses (LCA), a statistical technique used to find subtypes of related cases in a group, to identify discrete clusters of PLWH based on their past year substance use behaviors and lifetime arrest history. Multinomial logistic regressions were also performed, allowing researchers to identify key characteristics associated with class membership.

Five classes of substance users were identified:

1. minimal drug users,
2. cocaine users,
3. substantial cocaine/hazardous alcohol users,
4. problem polysubstance users, and
5. substantial cocaine/heroin users.

Also identified were three classes of arrest history:

1. minimal arrests,
2. non-drug arrests, and
3. drug-related arrests.

While several demographic variables such as age and being Black or Hispanic were associated with class membership for some of the latent classes, participation in substance use treatment was the only element that was significantly associated with membership in all classes in both substance use and arrest history models.

Conclusions: These findings are a first step toward better understanding the complex dynamics of substance use and of criminal justice system involvement among PLWH that may be useful in informing the future direction of research studies aiming to examine the complex interactions among substance use, criminal justice involvement, and HIV care. HIV intervention strategies may also need to take into consideration such nuanced differences to better inform patient care.

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