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)

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). Generalize...

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Published inAIDS and behavior Vol. 23; no. 3; pp. 649 - 660
Main Authors Tsuyuki, Kiyomi, Shoptaw, Steven J., Ransome, Yusuf, Chau, Gordon, Rodriguez-Diaz, Carlos E., Friedman, Ruth K., Srithanaviboonchai, Kriengkrai, Li, Sue, Mimiaga, Matthew J., Mayer, Kenneth H., Safren, Steven A.
Format Journal Article
LanguageEnglish
Published New York Springer US 01.03.2019
Springer Nature B.V
Subjects
Adhesion
Adult
Alcohol
Alcohol abuse
Alcohols
Anti-HIV Agents - therapeutic use
Antiretroviral drugs
Antiretroviral therapy
Brazil - epidemiology
Cannabis
Depression - psychology
Drug use
Drug Users
Female
Health Psychology
Heterosexuality
Heterosexuality - psychology
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - psychology
HIV Infections - virology
HIV-1 - drug effects
Homosexuality, Male - psychology
Human immunodeficiency virus
Humans
Infectious Diseases
Injection
Longitudinal Studies
Male
Marijuana
Medication Adherence - psychology
Medication Adherence - statistics & numerical data
Medicine
Medicine & Public Health
Men
Mens health
Mental depression
Middle Aged
Observational studies
Original Paper
Patient compliance
Public Health
Signs and symptoms
Statistical models
Stimulants
Substance abuse
Substance use
Substance-Related Disorders - complications
Substance-Related Disorders - epidemiology
Substance-Related Disorders - psychology
Symptoms
Thailand - epidemiology
Viral Load
Young Adult
Zambia - epidemiology
Brazil
Thailand
Zambia
Substance use
Adherence
Depression
HIV
Undetectable viral load
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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.
AbstractList 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.
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.
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.
Author Chau, Gordon
Li, Sue
Rodriguez-Diaz, Carlos E.
Mayer, Kenneth H.
Friedman, Ruth K.
Srithanaviboonchai, Kriengkrai
Mimiaga, Matthew J.
Shoptaw, Steven J.
Ransome, Yusuf
Tsuyuki, Kiyomi
Safren, Steven A.
AuthorAffiliation 5 University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
2 David Geffen School of Medicine, Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
4 Statistical Center for HIV/AIDS Research and Prevention (SCHARP), Fred Hutchinson Cancer Research Center, Seattle, WA, USA
8 Research Institute for Health Sciences, Chiang Mai University, Muang District, Chiang Mai, Thailand
7 Faculty of Medicine, Chiang Mai University, Muang District, Chiang Mai, Thailand
3 Harvard T.H. Chan School of Public Health, Boston, MA, USA
6 Instituto de Pesquisa Clinica Evandro Chagas, Rio de Janeiro, Brazil
9 Center for Health Equity Research, Brown University, Providence, RI, USA
11 Department of Psychology, University of Miami, Coral Gables, FL, USA
10 The Fenway Institute, Fenway Health, Boston, MA, USA
1 Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego (UCSD), 9500 Gilman Drive, MC 0507,
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/30725397$$D View this record in MEDLINE/PubMed
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Issue 3
Keywords Substance use
Adherence
Depression
HIV
Undetectable viral load
Language English
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Snippet The effect of non-injection substance use on HIV viral load (VL) is understudied in international settings. Data are from HPTN063, a longitudinal observational...
The effect of non-injection substance use on HIV viral load (VL) is understudied in international settings. Data are from HPTN063, a longitudinal observational...
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SubjectTerms Adhesion
Adult
Alcohol
Alcohol abuse
Alcohols
Anti-HIV Agents - therapeutic use
Antiretroviral drugs
Antiretroviral therapy
Brazil - epidemiology
Cannabis
Depression - psychology
Drug use
Drug Users
Female
Health Psychology
Heterosexuality
Heterosexuality - psychology
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - psychology
HIV Infections - virology
HIV-1 - drug effects
Homosexuality, Male - psychology
Human immunodeficiency virus
Humans
Infectious Diseases
Injection
Longitudinal Studies
Male
Marijuana
Medication Adherence - psychology
Medication Adherence - statistics & numerical data
Medicine
Medicine & Public Health
Men
Mens health
Mental depression
Middle Aged
Observational studies
Original Paper
Patient compliance
Public Health
Signs and symptoms
Statistical models
Stimulants
Substance abuse
Substance use
Substance-Related Disorders - complications
Substance-Related Disorders - epidemiology
Substance-Related Disorders - psychology
Symptoms
Thailand - epidemiology
Viral Load
Young Adult
Zambia - epidemiology
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Title 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)
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https://pubmed.ncbi.nlm.nih.gov/PMC6414080
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