Black women with HIV are impacted by mental health and substance use disorders alongside barriers to care. The impact of these disorders on retention in care, a crucial step of the HIV care continuum, has not been well-studied. We examined the association between these disorders and retention in care over a 2-year period. Data from January 1, 2011, to June 30, 2019, were obtained from the DC Cohort, an observational HIV study in Washington, District of Columbia. We examined the associations between mental health (i.e., mood-related or trauma-related) or substance use disorders, separately, on not being retained in HIV care over a 2-year interval post-enrollment among non-Hispanic Black women with HIV. Multivariate logistic regression with adjusted odds ratios (aORs) for sociodemographic and clinical variables was used to quantify the association of 1) having a confirmed mental health or substance use disorder and 2) not being retained in care. Among the 2,181 women in this analysis, 690 (31.64%) were not retained in care. The prevalence of a mood-related disorder (39.84%) was higher compared with a substance use (16.19%) or trauma-related disorder (7.75%). Age per a 10-year increase (aOR 0.87; confidence interval [CI] 0.80, 0.94) and a mood-related disorder diagnosis (aOR 0.72; CI: 0.59, 0.88) were inversely associated with not being retained in care. Mood-related disorders were prevalent among Black women with HIV in Washington, District of Columbia, but were not associated with worse retention in care. Future studies should examine key facilitators for Black women with HIV and coexisting mood-related disorders and how they impact retention in care.

中文翻译：

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哥伦比亚特区华盛顿黑人妇女艾滋病毒护理中的心理健康和药物使用与保留协会

感染艾滋病毒的黑人女性受到心理健康和药物滥用障碍以及护理障碍的影响。这些疾病对持续护理的影响（艾滋病毒护理连续体的关键步骤）尚未得到充分研究。我们研究了这些疾病与两年内保留护理之间的关联。 2011年1月1日至2019年6月30日的数据来自DC队列，这是一项位于华盛顿哥伦比亚特区的观察性艾滋病毒研究。我们分别研究了感染艾滋病毒的非西班牙裔黑人女性在入组后两年内未继续接受艾滋病毒护理的心理健康（即情绪相关或创伤相关）或物质使用障碍之间的关联。使用针对社会人口统计学和临床​​变量调整优势比 (aOR) 的多变量逻辑回归来量化 1) 已确诊的心理健康或物质使用障碍与 2) 未继续接受护理之间的关联。在本次分析的 2,181 名女性中，有 690 名 (31.64%) 没有接受护理。与情绪相关的疾病（39.84%）的患病率高于物质使用（16.19%）或创伤相关的疾病（7.75%）。每增加 10 年年龄（aOR 0.87；置信区间 [CI] 0.80, 0.94）和情绪相关疾病诊断（aOR 0.72；CI：0.59, 0.88）与未继续接受护理呈负相关。在华盛顿哥伦比亚特区，与情绪相关的疾病在感染艾滋病毒的黑人女性中很普遍，但与护理保留率较差无关。未来的研究应该研究感染艾滋病毒和共存情绪相关疾病的黑人女性的关键促进因素，以及它们如何影响护理的保留。