TABLE 3.
Associations Between Depression and Low PrEP Adherence* During Study Follow-up (n = 903 Participants)
|
HIV-Uninfected Women (N = 312) |
Visits With Low PrEP Adherence† (N = 386/1433 Visits) |
Unadjusted GEE Analysis | Adjusted GEE Analysis‡ | Adjusted MSM Analysis§ | |||
| RR (95% CI) | P | aRR (95% CI) | P | aRR (95% CI) | P | ||
| Probable depression║ | 39 (41.1) | 1.46 (1.05 to 2.03) | 0.02 | 1.77 (1.14 to 2.77) | 0.01 | 1.53 (1.05 to 2.23) | 0.03 |
| No probable depression | 347 (25.9) | REF | REF | REF | REF | REF | REF |
| HSCL-D mean score¶ | 1.12 (1.03–1.28) | 1.21 (0.82 to 1.80) | 0.33 | 1.80(1.03 to 3.14) | 0.03 | — | — |
|
HIV-Uninfected Men (N = 591) |
Visits With Low PrEP Adherence† (N = 890/2865 Visits) |
Unadjusted GEE Analysis | Adjusted GEE Analysis‡ | Adjusted MSM Analysis§ | |||
| RR (95% CI) | P | aRR (95% CI) | P | aRR (95% CI) | P | ||
| Probable depression║ | 29 (35.8) | 1.16 (0.75 to 1.81) | 0.49 | 1.18 (0.73 to 1.91) | 0.50 | 1.28 (0.78 to 2.12) | 0.32 |
| No probable depression | 861 (30.9) | REF | REF | REF | REF | REF | REF |
| HSCL-D mean score¶ | 1.11 (1.01–1.23) | 1.05 (0.87 to 1.27) | 0.63 | 1.05 (0.85 to 1.30) | 0.65 | — | — |
Participants were considered to have low adherence if they opened their pill bottles ,80% of the expected days between study visits, based on MEMS caps data.
Data are n/N (%) or median (IQR).
GEE models adjusted for study site, age, stigma, social support, fertility intentions, and condomless sex with their study partner since the previous visit, which were selected a priori, as well as relationship satisfaction with study partner, which resulted in a >10% change in the unadjusted RR in models for both men and women.
Weighted marginal structural model is adjusted for marital status, age, heavy alcohol use, relationship satisfaction, plasma HIV RNA concentration in the partner living with HIV, and depression history. We did not calculate the effect of mean HSCL-D score on PrEP adherence using marginal structural models because inverse probability weights generally perform poorly with continuous exposure variables.
Defined as HSCL-D mean score >1.75.
Defined as continuous HSCL-D score (range 0–4).
MSM, marginal structural models; RR, risk ratio.