Health Department Releases Data on Substance Use Among Persons Living With HIV/AIDS Receiving Care in New York City

Among cohort studied, data show that non-injection drug
use is more common than injection drug use

Additionally, substance users living with HIV/AIDS tend to be older,
Black or Latino, and identify as gay

December 12, 2016 – The Health Department today released an Epi Data Brief titled, “Substance Use among HIV-Positive Persons Receiving Medical Care in New York City: The Medical Monitoring Project 2013 and 2014.” The Medical Monitoring Project (MMP) is a Centers for Disease Control and Prevention sponsored national study of persons living with HIV/AIDS. Of the 845 participants in the New York City study, the data show that 13 percent reported any substance use in the past 12 months. The data also show that substance users living with HIV/AIDS within this study tend to be older, Black or Latino, and identify as gay. Among these users, crystal methamphetamine, poppers, cocaine, and crack were the most commonly used substances. With treatment and care, persons living with HIV/AIDS (PLWHA) can live long and healthy lives, but substance use can potentially compromise a person’s involvement in care and their health. The findings from the Epi Data Brief serves to inform drug user-focused HIV primary care and prevention among this population. The full Epi Data Brief can be found here (PDF). 

“These new data are a reminder that we must reduce disparities that exist in communities of color,” said Health Commissioner Dr. Mary T. Bassett. “We will continue to ensure that people living with HIV are provided access to quality care and treatment that leads to a longer life.”     

Epi Data Brief Highlights

  • More than one in 10 PLWHA participants reported any substance use (not including alcohol) in the past 12 months.
  • Less than 1 percent of PLWHA participants sampled were injection drug users.
  • Substance use in the past 12 months was four times higher in men than in women (17 percent versus 4 percent)
  • Nearly 40 percent of substance users were 50 years or older (38 percent), Black (37 percent) or Latino (37 percent).
  • The majority of substance users identified as gay (63 percent).
  • The prevalence of substance use in the past 12 months was more than four times higher among men who have sex with men (MSM) than among heterosexuals (26 percent vs. 6 percent).
  • Alcohol use in the past 30 days was reported by 48 percent of participants while 12 percent met a clinical definition of being binge drinkers. Nine percent of men and 3 percent of women were binge drinkers.
  • More than half of all PLWHA in the sample reported smoking cigarettes daily (54 percent). 

Data were collected through the Medical Monitoring Project (MMP) from 2013 and 2014. The MMP is a Centers for Disease Control and Prevention sponsored national study of persons living with HIV/AIDS. New York City is one of 23 jurisdictions that conduct MMP annually. Study eligibility criteria included being diagnosed with HIV infection, being 18 years of age or older and in care at a sampled facility between January 1st and April 30th in each of 2013 and 2014. The results presented are from 845 participants from 35 facilities in the 2013-2014 MMP cycles.

“People living with HIV can live long and healthy lives, but abusing alcohol and other substances will, like with any population, adversely affect their physical and mental health and be a barrier to staying healthy and seeking care,” said Assembly Member Richard Gottfried, Chair of the Assembly Committee on Health. “The Epi Data Brief released by the Health Department shows the need for care and prevention efforts that are directed to this population, like the de Blasio administration’s $25 million investment in education and training, its ThriveNYC mental health initiative, and the public awareness campaign on the dangers of excessive drinking.”

“Housing Works has followed a harm-reduction model since its founding, and we see firsthand that meeting people where they’re at works as an effective health intervention,” said Charles King, President and CEO of Housing Works. “In the early 1990s, when New York State’s AIDS epidemic was at its peak with about 15,000 new annual HIV infections, 80% of them here in New York City, over half of those newly infected New Yorkers were intravenous drug users (IDUs). Since then, that number has decreased over 96%, and today, only about 70 of the state’s roughly 2,500 annual new HIV infections are IDUs. Those results are due in no small part to harm reduction. Scaling up harm-reduction programs, including the implementation of Safe Injection Facilities and expanding access to PrEP for injection drug users, is one of the many ways we can bridge gaps in health disparities for all New Yorkers, and an essential component of our efforts to end the AIDS epidemic by 2020.”

"As we have been seeing the growing use of crystal methamphetamine in low-income communities of color, we applaud the Department of Health's methamphetamine-specific harm reduction initiative and ThriveNYC for pioneering responses to this important health issue", said Jason Walker, HIV/AIDS Community Organizer at VOCAL-NY.  "The expansion and enhancement of harm reduction services and mental health support for HIV+ New Yorkers in need of care is critical--not only for improving their individual health outcomes, but also for ending the HIV/AIDS epidemic that impacts all New Yorkers."

The Health Department supports several organizations to improve the health of drug using people living with HIV. Using federal Ryan White Program funds, the Department funds harm reduction services at 17 agencies across New York City providing evidence-based interventions to address the unique needs of substance using people living with HIV including individual, group, and family counseling and opioid overdose prevention services. Following the statistics on the increase in methamphetamine use in NYC, these programs have a focus on stimulant use and its negative effect to health, especially on adherence to HIV medication. Additionally, Ryan White funds support supportive counseling services at eight syringe exchange programs.

Additionally, the Health Department will launch the first municipally-funded program focused on crystal methamphetamine harm reduction in the United States. Supported primarily by the NYC Ending the Epidemic initiative announced by Mayor de Blasio and City Council, the program addresses the often overlooked role of this drug in the lives of people living with HIV or at risk of exposure.

In response to previous data suggesting high rates of opioid-involved overdose deaths, Mayor Bill de Blasio announced new initiatives this past April, which includes a three-year, $25 million investment to fund 10 critical programs that increase education efforts and training and expand surveillance. ThriveNYC, led by First Lady Chirlane McCray, also invests heavily in opioid treatment by increasing distribution and access to life-saving medications, such as naloxone and buprenorphine, in high-risk areas.

The Health Department also distributes naloxone to syringe access and other programs in New York City. This medication immediately reverses the effects of heroin and prescription painkillers and can save lives if bystanders and other first responders administer it to an overdosing person. The City will fund the distribution of 7,500 additional naloxone kits for community-based organizations serving people at risk for overdose and support them to hire peer educators to enhance capacity to distribute naloxone.

Addressing tobacco use among people living with HIV has been a priority of the Health Department since 2014. Tobacco dependency counseling and referrals are a component of several Ryan White services including medical case management, harm reduction, mental health and supportive counseling.

For more information on ThriveNYC, visit nyc.gov/thrivenyc.

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MEDIA CONTACT: Christopher Miller/Julien Martinez: (347) 396-4177,
PressOffice@health.nyc.gov