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)

Kiyomi Tsuyuki, Steven J. Shoptaw, Yusuf Ransome, Gordon Chau, Carlos E. Rodriguez-Diaz, Ruth K. Friedman, Kriengkrai Srithanaviboonchai, Sue Li, Matthew J. Mimiaga, Kenneth H. Mayer, Steven A. Safren

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)649-660
Number of pages12
JournalAIDS and Behavior
Volume23
Issue number3
DOIs
StatePublished - Mar 15 2019

Keywords

  • Adherence
  • Depression
  • HIV
  • Substance use
  • Undetectable viral load

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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