Table 3.
Unadjusted analysis of baseline and time-dependent factors associated with viral suppression.
| Variable | Baseline factors |
Time-dependent factors |
||
|---|---|---|---|---|
| OR (95% CI) | p value | OR (95% CI) | p value | |
| Age (years) | ||||
| 18–24 | 0.28 (0.10–0.80) | 0.02 | – | – |
| ≥25 | 1.00 (ref) | – | ||
| Education (years) | ||||
| 0–8 | 0.20 (0.05–0.82) | 0.03 | – | – |
| 9–12 | 0.36 (0.09–1.36) | 0.13 | – | – |
| 13 or more | 1.00 (ref) | – | ||
| Employment | ||||
| Less than full-time employed | 0.29 (0.10–0.84) | 0.02 | 0.58 (0.29–1.18) | 0.13 |
| Full-time employed | 1.00 (ref) | 1.00 (ref) | ||
| Perceived future financial status | ||||
| Uncertain or very uncertain | 1.12 (0.39–3.23) | 0.84 | 1.11 (0.56–2.21) | 0.76 |
| Secure or very secure | 1.00 (ref) | 1.00 (ref) | ||
| Resided in Kisumu for less than 1 year | ||||
| Yes | 1.17 (0.19–7.02) | 0.87 | – | – |
| No | 1.00 (ref) | – | ||
| Marital status | ||||
| Married or living with female partner | 1.93 (0.35–10.57) | 0.45 | 2.16 (0.92–5.11) | 0.08 |
| Separated or divorced from female partner | 0.84 (0.25–2.83) | 0.78 | 1.62 (0.66–3.97) | 0.29 |
| Single | 1.00 (ref) | 1.00 (ref) | ||
| Currently living with a male sexual partner | ||||
| No | 3.25 (1.15–9.19) | 0.03 | 1.39 (1.00–1.91) | 0.05 |
| Yes | 1.00 (ref) | 1.00 (ref) | ||
| Harmful alcohol use (AUDIT ≥ 8) | ||||
| No | 1.33 (0.48–3.66) | 0.58 | 0.66 (0.40–1.10) | 0.11 |
| Yes | 1.00 (ref) | 1.00 (ref) | ||
| Harmful substance use (DAST ≥ 3) | ||||
| Yes | 1.30 (0.39–4.30) | 0.67 | 0.67 (0.23–1.94) | 0.46 |
| No | 1.00 (ref) | 1.00 (ref) | ||
| MOS social support (continuous) | 1.02 (0.99–1.05) | 0.12 | 1.00 (0.99–1.01) | 0.60 |
| Coping self-efficacy (continuous) | – | – | 1.08 (1.03–1.13) | <0.01 |
| Severe depressive symptoms (PHQ-9 ≥ 15) | ||||
| Yes | 1.35 (0.36–4.99) | 0.66 | * | * |
| No | 1.00 (ref) | * | ||
| Any sexual abuse during childhood (CECA) | ||||
| Yes | 1.32 (0.47–3.67) | 0.60 | – | – |
| No | 1.00 (ref) | – | ||
| Any physical abuse during childhood (CECA) | ||||
| Yes | 1.10 (0.40–3.05) | 0.85 | – | – |
| No | 1.00 (ref) | – | ||
| Ever refused any services | ||||
| Yes | 0.73 (0.25–2.14) | 0.57 | 0.95 (0.59–1.55) | 0.85 |
| No | 1.00 (ref) | 1.00 (ref) | ||
| Experienced recent trauma due to same-sex behaviors (last three months) (USAID HPI) | ||||
| Yes | 0.93 (0.30–2.94) | 0.91 | 0.99 (0.48–2.05) | 0.99 |
| No | 1.00 (ref) | 1.00 (ref) | ||
| Ever had sex with a female partner | ||||
| Yes | 1.57 (0.53–4.66) | 0.42 | 1.50 (0.83–2.72) | 0.18 |
| No | 1.00 (ref) | 1.00 (ref) | ||
| Gay or homosexual sexual identity | ||||
| No | 1.23 (0.39–3.83) | 0.72 | – | – |
| Yes | 1.00 (ref) | – | ||
| Transactional sex (for which the participant received money, food, or housing) (last 3 months) | ||||
| Yes | 0.30 (0.09–1.06) | 0.06 | 0.83 (0.53–1.31) | 0.43 |
| No | 1.00 (ref) | 1.00 (ref) | ||
| Always protected AI with a man (last 3 months) | ||||
| No | 1.36 (0.44–4.20) | 0.60 | 1.26 (0.65–2.46) | 0.49 |
| Yes | 1.00 (ref) | 1.00 (ref) | ||
| Usual sexual position during AI with a male partner | ||||
| Receptive or versatile | 0.25 (0.08–0.78) | 0.02 | 0.35 (0.17–0.71) | <0.01 |
| Insertive | 1.00 (ref) | 1.00 (ref) | ||
| Circumcision status | ||||
| No | 1.91 (0.53–6.85) | 0.32 | 2.12 (0.66–6.86) | 0.21 |
| Yes | 1.00 (ref) | 1.00 (ref) | ||
| Received treatment for any STI symptoms (last 3 months) | ||||
| Yes | 6.17 (0.81–46.99) | 0.08 | 0.50 (0.19–1.31) | 0.16 |
| No | 1.00 (ref) | 1.00 (ref) | ||
| Any CT and/or NG infection | ||||
| Yes | 1.84 (0.56–6.06) | 0.31 | 0.32 (0.07–1.56) | 0.16 |
| No | 1.00 (ref) | 1.00 (ref) | ||
| HIV diagnosis status | ||||
| Newly diagnosed and out-of-care | 0.37 (0.11–1.31) | 0.12 | – | – |
| Previously diagnosed and out-of-care | 1.00 (ref) | – | ||
| WHO clinical stage | ||||
| WHO clinical stage 2, 3, or 4 | 2.90 (0.72–11.74) | 0.14 | – | – |
| WHO clinical stage 1 | 1.00 (ref) | – | ||
| CD4 count (cells/μL) (continuous) | 1.00 (1.00–1.00) | 0.26 | – | – |
| CD4 count (cells/μL) | ||||
| ≥200 | * | * | – | – |
| <200 | * | – | ||
| Viral load (log10) at baseline (continuous) | 0.56 (0.37–0.85) | 0.01 | – | – |
| Viral suppression at baseline | ||||
| Not suppressed (≥1,000 copies/mL) | 0.11 (0.02–0.58) | 0.01 | – | – |
| Suppressed (<1,000 copies/mL) | 1.00 (ref) | – | ||
| Time | ||||
| Month 12 | – | – | 0.84 (0.56–1.27) | 0.41 |
| Month 6 | – | 1.00 (ref) | ||
*
Bivariable model was not estimable.
OR odds ratio; CI confidence interval; IQR interquartile range; AUDIT Alcohol Use Disorders Identification Test; DAST Drug Abuse Screening Test; MOS Medical Outcome Study; PHQ-9 Personal Health Questionnaire-9; CECA Childhood Exposure to Care and Abuse; USAID HPI United States Agency for International Development Health Policy Initiative; AI anal intercourse; STI sexually transmitted infection; CT Chlamydia trachomatis; NG Neisseria gonorrhea; WHO World Health Organization.