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https://www.arca.fiocruz.br/handle/icict/32221
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Open access
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2020-02-07
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- INI - Artigos de Periódicos [3646]
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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
Affilliation
University of California, San Diego. Department of Medicine. Division of Infectious Diseases and Global Public Health. San Diego, CA , USA.
University of California, Los Angeles. David Gefen School of Medicine. Department of Family Medicine. Los Angeles, CA, USA.
Harvard T.H. Chan School of Public Health. Boston, MA, USA.
Fred Hutchinson Cancer Research Center. Statistical Center for HIV/AIDS Research and Prevention. Seattle, WA, USA.
University of Puerto Rico. Medical Sciences Campus. San Juan, Puerto Rico.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clinica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Chiang Mai University. Faculty of Medicine. Chiang Mai, Thailand / Chiang Mai University. Research Institute for Health Sciences. Chiang Mai, Thailand.
Fred Hutchinson Cancer Research Center. Statistical Center for HIV/AIDS Research and Prevention. Seattle, WA, USA.
Brown University. Center for Health Equity Research. Providence, RI, USA
The Fenway Institute. Fenway Health. Boston, MA, USA.
University of Miami. Department of Psychology. Coral Gables, FL, USA.
University of California, Los Angeles. David Gefen School of Medicine. Department of Family Medicine. Los Angeles, CA, USA.
Harvard T.H. Chan School of Public Health. Boston, MA, USA.
Fred Hutchinson Cancer Research Center. Statistical Center for HIV/AIDS Research and Prevention. Seattle, WA, USA.
University of Puerto Rico. Medical Sciences Campus. San Juan, Puerto Rico.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clinica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Chiang Mai University. Faculty of Medicine. Chiang Mai, Thailand / Chiang Mai University. Research Institute for Health Sciences. Chiang Mai, Thailand.
Fred Hutchinson Cancer Research Center. Statistical Center for HIV/AIDS Research and Prevention. Seattle, WA, USA.
Brown University. Center for Health Equity Research. Providence, RI, USA
The Fenway Institute. Fenway Health. Boston, MA, USA.
University of Miami. Department of Psychology. Coral Gables, FL, USA.
Abstract
The efect 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 signifcantly 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.
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