Correlates of drug use cessation among participants in the Canadian HIV–HCV Co-infection Cohort

BackgroundOngoing drug use remains a barrier to HIV and HCV treatment. We examined the occurrence and correlates of drug use cessation among HIV–HCV co-infected drug users participating in HIV care.MethodsParticipants from the Canadian Co-infection Cohort reporting drug use (injecting drugs and/or smoking crack) with at least two follow-up visits were included (n = 521 (43%), 1832 visits). Socio-demographics, behavioural, and health information were collected at each six-month visit. Associations with cessation (no drug use since last visit) were examined using non-linear mixed effects logistic regression models with random intercepts.ResultsDuring follow-up, 361 (69%) participants ceased using drugs. Having a fixed address (aOR [adjusted odds ratio] 1.73, CI [95% confidence interval] 1.02–2.96) and smoking crack without injecting drugs (aOR 3.10, CI 2.05–4.71) were positively associated. Living alone (aOR 0.47, CI 0.35–0.63), current tobacco use (aOR 0.41, CI 0.26–0.64), hazardous alcohol drinking (aOR 0.67, CI 0.49–0.91), snorting drugs (aOR 0.52, CI 0.37–0.74), having a greater exposure to addiction programmes (aOR 0.88, CI 0.81–0.94), having been recruited in Quebec or Nova Scotia (aOR 0.41, CI 0.25–0.66), and British Columbia or Alberta (aOR 0.51, CI 0.32–0.82) were negatively associated. Various socio-demographic (age, education) and health-related (HIV duration, care adherence) factors were not associated.ConclusionDrug use cessation among HIV–HCV co-infected persons is relatively common in this cohort. Stable housing and supportive living situations seem to be important facilitators for drug use cessation in this population. Greater efforts should be made to retain patients in addiction treatment programmes.