Results
The baseline demographics and characteristics of each cohort are presented in Table 1. The mean age of participants was 24.5 (SD 3.6) years in the earliest study (PREVENT; 2004–2005) and increased to 33.3 (SD 4.6) years in the most recent study (ARCH; 2012–2015). The majority of participants in the cohorts were male (59% in PREVENT and HERMITAGE, 68% in LINC, and 71% in Russia ARCH). Employment decreased with each subsequent cohort: 35% reported unemployment in PREVENT and 65% in Russia ARCH. The majority of participants had completed secondary education in all cohorts.
Alcohol use was common in the cohorts; however, the entry criteria for some studies required alcohol use. Past month cannabis use was also common, with 47% reporting past 30-day cannabis use in 2004–2005, 37% in 2007–2010, 65% in 2013–2014, and 25% in 2012–2015. Among the three studies that assessed smoking, > 90% of participants in each cohort were regular smokers. Information on methadone use, specifically, was collected in two cohorts; in 2004–2005, 6% of participants reported past 30-day methadone use, and in 2012–2015, 80% of cohort participants reported methadone use in the past year (Table 1).
Use of only illicit opioids other than heroin appeared to increase over time, from 0% in PREVENT (2004–2005) to 4% (95% CI 2, 7%) in HERMITAGE (2007–2010) to 31% (95% CI 23, 40%) in LINC (2013–2014) to 46% (95% CI 37, 56%) in Russia ARCH (2012–2015). Furthermore, the use of other opioids in combination with heroin increased from 6% (95% CI 0, 29%) in PREVENT (2004–2005) to 26% (95% CI 21, 32%) in HERMITAGE (2007–2010) to 31% (95% CI 23, 40%) in Russia ARCH (2012–2015). Use of only heroin consistently decreased over the 10-year span, from 94% (95% CI 71, 100%) in PREVENT (2004–2005) to 70% (95% CI 64, 75%) in HERMITAGE (2007–2010) to 30% (95% CI 22, 39%) in LINC (2013–2014) to 23% (95% CI 16, 32%) in ARCH (2012–2015) (Figure 1).
Figure 1.
Patterns of past 30-day opioid use, by cohort.
HIV Medicine. 2019;20(7):450-455. © 2019 Blackwell Publishing
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