Table III:
Effects of Symptoms of Depression, Use of Antidepressants, and Substance Misuse on HIV Continuum of Care
| Substance Use | Symptoms of Depression |
Concurrent Antidepressant Use (n) |
Retention in Care, AOR, 95% Cl |
Receipt of ART, AOR, 95% CI |
Virologic Suppression, AOR, 95% Cl |
|---|---|---|---|---|---|
| Moderate Alcohol Use | No-Mild | No (13,357) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Yes (4,187) | 1.28 [1.18–1.40] | 2.53 [2.03–3.15] | 1.13 [1.03–1.23] | ||
| Moderate-Severe | No (2,514) | 1.19 [1.08–1.31] | 0.97 [0.85–1.11] | 0.85 [0.78–0.92] | |
| Yes (1,801) | 1.45 [1.29–1.63] | 2.20 [1.78–2.72] | 1.09 [0.98–1.21] | ||
| Moderate Alcohol Use | No-Mild | No (13,901) | 0.85 [0.80–0.90] | 1.04 [0.95–1.14] | 1.04 [0.98–1.11] |
| Yes (3,380) | 1.15 [1.05–1.27] | 2.00 [1.59–2.51] | 1.08 [0.99–1.19] | ||
| Moderate-Severe | No (2,533) | 1.08 [0.97–1.20] | 0.87 [0.76–1.00] | 0.76 [0.69–0.84]* | |
| Yes (1,621) | 1.34 [118–1.51] | 2.02 [1.50–2.72] | 1.14 [1.01–1.28] | ||
| Heavy Alcohol Use | No-Mild | No (11,648) | 0.79 [0.74–0.84] | 0.93 [0.84–1.03] | 1.00 [0.94–1.07] |
| Yes (2,620) | 1.05 [0.94–1.16] | 2.00 [1.57–2.55] | 1.14 [1.03–1.27] | ||
| Moderate-Severe | No (2,824) | 0.92 [0.83–1.03] | 0.84 [0.72–0.98] | 0.74 [0.67–0.82]† | |
| Yes (1,615) | 1.12 [0.98–1.271 | 1.85 [1.46–2.331 | 0.99 [0.88–1.111 | ||
| Recent Cocaine Use | No-Mild | No (2,274) | 1.03 [0.92–1.14] | 0.83 [0.72–0.96] | 0.79 [0.71–0.88] |
| Yes (625) | 1.21 [0.99–1.48] | 1.71 [1.17–2.51] | 1.00 [0.82–1.21] | ||
| Moderate-Severe | No (946) | 1.30 [1.07–1.58] | 0.83 [0.65–1.05] | 0.73 [0.61–0.86] | |
| Yes (491) | 1.42 [1.12–1.801 | 2.06 [1.32–3.231 | 0.91 [0.74–1.121 | ||
| Recent Opioid Use | No-Mild | No (690) | 1.06 [0.87–1.30] | 1.06 [0.81–1.38] | 0.86 [0.72–1.03] |
| Yes (222) | 1.58 [1.16–2.17] | 3.76 [1.67–8.46] | 1.09 [0.82–1.46] | ||
| Moderate-Severe | No (446) | 0.97 [0.76–1.24] | 0.99 [0.68–1.44] | 0.85 [0.69–1.06] | |
| Yes (218) | 1.52 [1.13–2.061 | 2.10 [1.32–3.331 | 0.97 [0.75–1.261 | ||
| Recent Methamphetamine Use | No-Mild | No (2,584) | 0.97 [0.87–1.07] | 1.02 [0.89–1.16] | 0.71 [0.64–0.79] |
| Yes (547) | 1.15 [0.94–1.42] | 2.45 [1.75–3.44] | 0.80 [0.65–0.98] | ||
| Moderate-Severe | No (1,440) | 1.18 [1.00–1.40] | 0.97 [0.79–1.19] | 0.60 [0.52–0.70] | |
| Yes (510) | 1.30 [1.03–1.65] | 1.91 [1.31–2.79] | 0.73 [0.59–0.92] |
Models adjusted for clinic site, age, sex, race, whether subjects were men who have sex with men (MSM), and time since enrollment in the cohort.AOR = adjusted odds ratio, CI = confidence interval. *,†The association between substance use and the outcome in the presence of symptoms of depression given antidepressant use is significantly than would be expected from the associations with substance use and symptoms of depression alone.
*
P-value for interaction is 0.016.
†
P-value for interaction is 0.040.