Table 1.
Demographic, socioeconomic, HIV‐related and health‐related factors, and associations with inaccurate self‐report of clinic viral load level, among 2771 HIV‐diagnosed participants on antiretroviral therapy (ART)
| Prevalence (N = 2771)a | Inaccurate self‐report of clinic viral loadc (n/N = 434/2678)b | Unadjusted PR and 95% CId | Adjusted PR and 95% CId | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| N | % | n/N | Row % | PR | 95% CI | P‐value | PR | 95% CI | P‐value | |
| Gender/sexual orientation (N = 2771) | ||||||||||
| MSMe | 1891 | 68.2 | 225/1852 | 12.1 | 1 | 1 | ||||
| Heterosexual men | 333 | 12.0 | 91/312 | 29.2 | 2.4 | 1.9, 3.0 | 1.8 | 1.4, 2.4 | ||
| Women | 547 | 19.7 | 118/514 | 23.0 | 1.9 | 1.5, 2.3 | < 0.001 | 1.3 | 1.0, 1.8 | < 0.001 |
| Age at recruitment (N = 2713) | ||||||||||
| < 30 yearse | 103 | 3.8 | 29/99 | 29.3 | 1 | 1 | ||||
| 30–39 years | 569 | 21.0 | 105/550 | 19.1 | 0.7 | 0.5, 0.9 | 0.8 | 0.6, 1.1 | ||
| 40–49 years | 1204 | 44.4 | 170/1157 | 14.7 | 0.5 | 0.4, 0.7 | 0.7 | 0.5, 0.9 | ||
| 50–59 years | 640 | 23.6 | 84/632 | 13.3 | 0.5 | 0.3, 0.7 | 0.7 | 0.5, 1.0 | ||
| ≥ 60 years | 197 | 7.3 | 31/189 | 16.4 | 0.6 | 0.4, 0.9 | 0.002 (t) | 0.8 | 0.5, 1.2 | 0.16 (t) |
| Ethnicity (N = 2771) | ||||||||||
| Whitee | 1894 | 68.4 | 231/1854 | 12.5 | 1 | 1 | ||||
| Black African | 533 | 19.2 | 134/498 | 26.9 | 2.2 | 1.8, 2.6 | 1.5 | 1.2, 2.0 | ||
| Black Caribbean or black other | 94 | 3.4 | 20/89 | 22.5 | 1.8 | 1.2, 2.7 | 1.4 | 0.9, 2.1 | ||
| Other/missing | 250 | 9.0 | 49/237 | 20.7 | 1.7 | 1.3, 2.2 | < 0.001 | 1.4 | 1.0, 1.8 | 0.015 |
| UK birth/fluency in spoken English (N = 2684) | ||||||||||
| Born in the UKe | 1529 | 57.0 | 185/1491 | 12.4 | 1 | 1.0 | ||||
| Non‐UK born, fluent in spoken English | 899 | 33.5 | 147/871 | 16.9 | 1.4 | 1.1, 1.7 | 1.0 | 0.8, 1.3 | ||
| Non‐UK born, speaks English quite well | 233 | 8.7 | 70/215 | 32.6 | 2.6 | 2.1, 3.3 | 1.7 | 1.3, 2.3 | ||
| Non‐UK born, speaks English not at all well | 23 | 0.9 | 17/23 | 73.9 | 6.0 | 4.5, 7.9 | < 0.001 (t) | 3.5 | 2.4, 5.1 | < 0.001 (t) |
| Education (N = 2696) | ||||||||||
| University educatione | 1115 | 41.4 | 115/1084 | 10.6 | 1 | 1 | ||||
| A levels/O levels or equivalent; other nonuniversity | 1274 | 47.3 | 218/1237 | 17.6 | 1.7 | 1.3, 2.1 | 1.6 | 1.3, 2.0 | ||
| No educational qualifications | 307 | 11.4 | 90/291 | 30.9 | 2.9 | 2.3, 3.7 | < 0.001 (t) | 2.7 | 2.1, 3.4 | < 0.001 (t) |
| Employment status (N = 2699) | ||||||||||
| Employed (full or part‐time)e | 1509 | 55.9 | 182/1461 | 12.5 | 1 | 1 | ||||
| Unemployed | 496 | 18.4 | 118/477 | 24.7 | 2.0 | 1.6, 2.4 | 1.7 | 1.4, 2.1 | ||
| Not working because of sickness/disability | 380 | 14.1 | 63/370 | 17.0 | 1.4 | 1.1, 1.8 | 1.6 | 1.3, 2.1 | ||
| Retired | 180 | 6.7 | 25/174 | 14.4 | 1.2 | 0.8, 1.7 | 1.3 | 0.8, 2.0 | ||
| Other (looking after home/family, carer, student or other) | 134 | 5.0 | 32/131 | 24.4 | 2.0 | 1.4, 2.7 | < 0.001 | 1.4 | 1.0, 2.0 | < 0.001 |
| Housing (N = 2720) | ||||||||||
| Homeownere | 959 | 35.3 | 91/938 | 9.7 | 1 | 1 | ||||
| Renting (council or housing association) | 1482 | 54.5 | 255/1431 | 17.8 | 1.8 | 1.5, 2.3 | 1.5 | 1.2, 1.9 | ||
| Unstable/other (temporary, staying with friends or homeless) | 279 | 10.3 | 79/261 | 30.3 | 3.1 | 2.4, 4.1 | < 0.001 (t) | 2.1 | 1.6, 2.8 | < 0.001 (t) |
| Money for basic needs, e.g. food and heating (N = 2717) | ||||||||||
| Alwayse | 1189 | 43.8 | 121/1160 | 10.4 | 1 | 1 | ||||
| Mostly | 708 | 26.1 | 104/692 | 15.0 | 1.4 | 1.1, 1.8 | 1.4 | 1.1, 1.7 | ||
| Sometimes | 483 | 17.8 | 103/461 | 22.3 | 2.1 | 1.7, 2.7 | 1.8 | 1.4, 2.3 | ||
| No | 337 | 12.4 | 97/315 | 30.8 | 3.0 | 2.3, 3.7 | < 0.001 (t) | 2.4 | 1.9, 3.1 | < 0.001 (t) |
| Low supportive network (score ≤ 12; modified Duke FSSQ) (N = 2731) | ||||||||||
| Noe | 2343 | 85.8 | 349/2268 | 15.4 | 1 | 1 | ||||
| Yes | 388 | 14.2 | 75/377 | 19.9 | 1.3 | 1.0, 1.6 | 0.041 | 1.4 | 1.1, 1.7 | 0.016 |
| Partner status (N = 2752) | ||||||||||
| HIV‐positive stable partnere | 660 | 24.0 | 88/633 | 13.9 | 1 | 1 | ||||
| HIV‐negative or unknown status stable partner | 905 | 32.9 | 128/878 | 14.6 | 1.0 | 0.8, 1.3 | 1.0 | 0.8, 1.3 | ||
| No stable partner | 1187 | 43.1 | 216/1150 | 18.8 | 1.4 | 1.1, 1.7 | 0.008 | 1.4 | 1.1, 1.8 | 0.001 |
| Disclosed HIV status? (other than to health care staff) (N = 2754) | ||||||||||
| Yese | 2536 | 92.1 | 362/2464 | 14.7 | 1 | 1 | ||||
| No | 218 | 7.9 | 64/199 | 32.2 | 2.2 | 1.8, 2.7 | < 0.001 | 1.7 | 1.3, 2.1 | < 0.001 |
| Time since clinic‐recorded VL result (N = 2742) | ||||||||||
| ≤ 1 monthe | 889 | 32.4 | 125/874 | 14.3 | 1 | 1 | ||||
| 1–6 months | 1601 | 58.4 | 263/1564 | 16.8 | 1.2 | 1.0, 1.4 | 1.1 | 0.9, 1.4 | ||
| > 6 months | 252 | 9.2 | 46/240 | 19.2 | 1.3 | 1.0, 1.8 | 0.039 (t) | 1.3 | 1.0, 1.7 | 0.073 (t) |
| Time since started ART (N = 2681) | ||||||||||
| ≤ 6 monthse | 166 | 6.2 | 51/159 | 32.1 | 1 | 1 | ||||
| 6 months to 1 year | 104 | 3.9 | 20/102 | 19.6 | 0.6 | 0.4, 1.0 | 0.6 | 0.4, 1.0 | ||
| 1–2 years | 191 | 7.1 | 28/175 | 16.0 | 0.5 | 0.3, 0.8 | 0.5 | 0.3, 0.8 | ||
| 2–5 years | 531 | 19.8 | 89/521 | 17.1 | 0.5 | 0.4, 0.7 | 0.6 | 0.4, 0.7 | ||
| 5–10 years | 710 | 26.5 | 107/683 | 15.7 | 0.5 | 0.4, 0.6 | 0.5 | 0.4, 0.7 | ||
| > 10 years | 979 | 36.5 | 107/958 | 11.2 | 0.3 | 0.3, 0.5 | < 0.001 (t) | 0.4 | 0.3, 0.6 | < 0.001(t) |
| ART adherence: ART doses missed in past 2 weeks (N = 2756) | ||||||||||
| Nonee | 2068 | 75.0 | 293/2006 | 14.6 | 1 | 1 | ||||
| One | 370 | 13.4 | 59/358 | 16.5 | 1.1 | 0.9, 1.5 | 1.2 | 0.9, 1.5 | ||
| Two | 160 | 5.8 | 32/154 | 20.8 | 1.4 | 1.0, 2.0 | 1.5 | 1.1, 2.1 | ||
| Three or more | 158 | 5.7 | 46/150 | 30.7 | 2.1 | 1.6, 2.7 | < 0.001 (t) | 2.1 | 1.7, 2.7 | < 0.001 (t) |
| ART adherence: ever missed two consecutive days of ART in past 3 months? (N = 2757) | ||||||||||
| Noe | 2283 | 82.8 | 322/2209 | 14.6 | 1 | 1 | ||||
| Yes, once | 155 | 5.6 | 25/151 | 16.6 | 1.1 | 0.8, 1.6 | 1.1 | 0.8, 1.6 | ||
| Yes, two to three times | 199 | 7.2 | 47/193 | 24.4 | 1.7 | 1.3, 2.2 | 1.5 | 1.2, 2.0 | ||
| Yes, more than three times | 120 | 4.4 | 37/114 | 32.5 | 2.2 | 1.7, 3.0 | < 0.001 (t) | 2.2 | 1.6, 2.9 | < 0.001 (t) |
| Depressive symptoms (PHQ‐9 score ≥ 10) (N = 2771) | ||||||||||
| Noe | 2023 | 73.0 | 265/1955 | 13.6 | 1 | 1 | ||||
| Yes | 748 | 27.0 | 169/723 | 23.4 | 1.7 | 1.5, 2.1 | < 0.001 | 1.9 | 1.6, 2.2 | < 0.001 |
| Anxiety symptoms (GAD‐7 score ≥ 10) (N = 2771) | ||||||||||
| Noe | 2154 | 77.7 | 301/2082 | 14.5 | 1 | 1 | ||||
| Yes | 617 | 22.3 | 133/596 | 22.3 | 1.5 | 1.3, 1.9 | < 0.001 | 1.6 | 1.3, 1.9 | < 0.001 |
| Treatment (medical or other) for depression (N = 2771) | ||||||||||
| Noe | 2206 | 79.6 | 334/2133 | 15.7 | 1 | 1 | ||||
| Yes | 565 | 20.4 | 100/545 | 18.3 | 1.2 | 1.0, 1.4 | 0.14 | 1.3 | 1.1, 1.6 | 0.013 |
MSM, men who have sex with men; CI, confidence interval; FSSQ, Functional Social Support Questionnaire; PR, prevalence ratio; PHQ‐9, Patient Health Questionnaire, 9 item scale; GAD‐7, Generalized Anxiety Disorder 7 item scale; (t), test for linear trend across categories performed.
For explanatory variables with missing values for > 30 participants, the prevalence of inaccurate self‐report among the subgroup with a missing value ranged from 16.7% (among those with missing education status) to 40.0% (among those with missing time since started ART).
Prevalence among participants on ART at the time of the questionnaire.
Disagreement between clinic‐recorded and self‐reported undetectable VL status, or “don't know” response for self‐report.
Analysis excludes 93 of 2771 individuals on ART. Exclusions were: missing clinic‐recorded viral load (n = 18); clinic‐recorded viral load dated after questionnaire issue (n = 11); missing self‐reported viral load (n = 64).
Unadjusted and adjusted prevalence ratios and 95% confidence intervals using modified Poisson regression. For adjusted analyses, each factor is included in a separate model and adjusted for “gender/sexual orientation”, “age group”, “ethnicity” and “time since started ART group”. Denominators are equivalent for unadjusted and adjusted analyses, as in multivariable models, “age group” and “time since started ART” were fitted using a “missing” category (n = 51 and n = 80 missing values, respectively). P values were obtained using the score statistic.
Reference category.