1. The Longitudinal Effects of Non-injection Substance Use on Sustained HIV Viral Load Undetectability Among MSM and Heterosexual Men in Brazil and Thailand: The Role of ART Adherence and Depressive Symptoms (HPTN 063)
- Author
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Carlos E. Rodríguez-Díaz, Sue Li, Gordon Chau, Ruth Khalili Friedman, Steven Shoptaw, Yusuf Ransome, Kriengkrai Srithanaviboonchai, Kiyomi Tsuyuki, Steven A. Safren, Matthew J. Mimiaga, and Kenneth H. Mayer
- Subjects
Male ,Psychological intervention ,HIV Infections ,Substance use ,Drug Users ,0302 clinical medicine ,Longitudinal Studies ,030212 general & internal medicine ,Depression (differential diagnoses) ,biology ,Depression ,Substance Abuse ,Homosexuality ,Middle Aged ,Viral Load ,Thailand ,Mental Health ,Infectious Diseases ,Polysubstance dependence ,Public Health and Health Services ,HIV/AIDS ,Female ,Public Health ,Infection ,0305 other medical science ,Viral load ,Brazil ,Adult ,Drug Abuse (NIDA Only) ,Social Work ,medicine.medical_specialty ,Social Psychology ,Anti-HIV Agents ,Substance-Related Disorders ,Zambia ,Article ,Medication Adherence ,Odds ,Young Adult ,03 medical and health sciences ,Clinical Research ,Behavioral and Social Science ,medicine ,Undetectable viral load ,Humans ,Homosexuality, Male ,Heterosexuality ,030505 public health ,business.industry ,Prevention ,Public health ,Public Health, Environmental and Occupational Health ,HIV ,biology.organism_classification ,Adherence ,HIV-1 ,Observational study ,Cannabis ,business ,Demography - Abstract
The effect of non-injection substance use on HIV viral load (VL) is understudied in international settings. Data are from HPTN063, a longitudinal observational study of HIV-infected individuals in Brazil, Thailand, and Zambia, with focus on men with VL data (Brazil = 146; Thailand = 159). Generalized linear mixed models (GLMM) assessed whether non-injection substance use (stimulants, cannabis, alcohol, polysubstance) was associated with VL undetectability. ART adherence and depressive symptoms were examined as mediators of the association. In Thailand, substance use was not significantly associated with VL undetectability or ART adherence, but alcohol misuse among MSM was associated with increased odds of depression (AOR = 2.75; 95% CI 1.20, 6.32, p = 0.02). In Brazil, alcohol misuse by MSM was associated with decreased odds of undetectable VL (AOR = 0.34; 95% CI 0.13, 0.92, p = 0.03). Polysubstance use by heterosexual men in Brazil was associated with decreased odds of ART adherence (AOR = 0.25; 95% CI 0.08, 0.78, p = 0.02). VL suppression appears attainable among non-injection substance users. Substance use interventions among HIV-positive men should address depression, adherence, and VL undetectability.
- Published
- 2019
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