Cancer has become more common among persons with HIV. After examination of cumulative cancer incidence by age 75 years and calendar trends in cumulative incidence and hazard rates, it was determine... Background: Cancer is increasingly common among persons with HIV. Objective: To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status. Design: Cohort study. Setting: ...

Greater integration of medication-assisted treatment for opioid use disorder in U.S. primary care settings would expand access to treatment for this condition. This article summarizes findings of a... Greater integration of medication-assisted treatment (MAT) for opioid use disorder (OUD) in U.S. primary care settings would expand access to treatment for this condition. Models for integrating MA...

The US overdose epidemic continues to accelerate despite extensive attempts to expand treatment for opioid use disorder and overdose prevention services. An estimated 100 306 people died of an overdose between April 2020 and March 2021, the greatest number of overdoses ever in a 12-month period.¹ Reasons for increased overdose rates are multifactorial and include the increasing dominance of fentanyl in the opioid drug supply and its addition to psychostimulants, increases in psychostimulant use that appear to exacerbate the risk of overdose,² and the COVID-19 pandemic.³ The age-adjusted rate of drug overdose deaths involving psychostimulants, including methamphetamine, increased 10-fold from 0.5 per 100 000 people in 2009 to 5.0 per 100 000 people in 2019.⁴ Although both cocaine and methamphetamine combined with opioids increase the risk of overdose,⁵ methamphetamine is associated with an increased risk of overdose, regardless of opioid use.⁴

HIV infection and substance use disorders are chronic diseases with complex contributions to health-related quality of life (HRQOL). We conducted a cross-sectional survey of 951 HIV-infected adults receiving care at 14 HIV Research Network sites in 2003 to estimate associations between HRQOL and specific substance use among HIV-infected patients. HRQOL was assessed by multi-item measures of physical and role functioning, general health, pain, energy, positive affect, anxiety, and depression. Mental and physical summary scales were developed by factor analysis. We used linear regression to estimate adjusted associations between HRQOL and current illicit use of marijuana, analgesics, heroin, amphetamines, cocaine, sedatives, inhalants, hazardous/binge alcohol, and drug use severity. Current illicit drug use was reported by 37% of subjects. Mental HRQOL was reduced for current users [adjusted β coefficient −9.66, 95% confidence interval [(CI]) −13.4, −5.94] but not former users compared with never users. Amphetamines and sedatives were associated with large decreases in mental (amphetamines: β = −22.8 [95% CI −33.5, −12.0], sedatives: β = −18.6 [95% CI −26.2, −11.0]), and physical HRQOL (amphetamines: β = −11.5 [95% CI −22.6, −0.43], sedatives: β = −13.2 [95% CI −21.0, −5.36]). All illicit drugs were associated with decreased mental HRQOL: marijuana (β = −7.72 [95% CI −12.0, −3.48]), non-prescription analgesics (β = −13.4 [95% CI −20.8, −6.07]), cocaine (β = −10.5 [95% CI −16.4, −4.67]), and inhalants (β = −14.0 [95% CI −24.1, −3.83]). Facilitating sobriety for patients with attention to specific illicit drugs represents an important avenue for elevating HRQOL in patients living with HIV.