Exploring Associations Between Social Factors and Current Substance Use Among Older African Americans with HIV

Background: Substance use is highly prevalent among older people with HIV and continues to have a negative impact on engagement along the HIV care continuum, particularly among African Americans (AA). Social factors like resource insecurity, stigma, and discrimination may play a role in substance use behaviors. However, there is limited research on how these social factors impact substance use among older people with HIV.

Objectives: The purpose of this descriptive study was to examine associations between demographic and social factors and substance use among older AAs with HIV.

Results: Fifty-two participants who were ≥50 years of age, living in Ohio, and identified as Black or AA completed an online survey. Past three-month substance use was self-reported for alcohol, opioids, cocaine, cannabis, and/or amphetamine type stimulants. Separate unadjusted, logistic regression models were conducted to examine factors between each type of substance and HIV-related stigma, food and housing insecurity, discrimination, history of incarceration, employment status, and demographics. The majority of participants self-reported past three-month use of cocaine (53.8%), cannabis (67.3%), amphetamine type stimulants (51.9%), and risky alcohol use (85.0%), and half reported opioid use. HIV-related stigma, discrimination, and housing insecurity were all associated with increased odds of opioid, cocaine, and amphetamine use. Discrimination, food, and housing insecurity were associated with increased odds of cannabis use and risky alcohol use.

Conclusions: More research is needed to further understand how social factors impact substance use among older people with HIV. This understanding can lead to interventions that target these social factors which in turn reduces substance use.