Table 2.
Relationship of Viral Suppression with Risk Behavior, HIV, and LTC Case Management Related Characteristics, SMILE Collaborative, 2012-2015
| Total | BLD | >BLD | Unadjusted | Adjusted | |||
|---|---|---|---|---|---|---|---|
| N=453 | N=135 | N=318 | |||||
| n (col %) | n (row %) | n (row %) | HR (95% CI) | p-value | HR (95% CI) | p-value | |
| Used ≥ 1 substance in past 6 months* | |||||||
| Yes | 245 (54.1) | 67 (27.3) | 178 (72.7) | 0.68 (0.48 - 0.95) | 0.0237 | ||
| No | 208 (45.9) | 68 (32.7) | 140 (67.3) | 1 | |||
| Had sex with an anonymous partner in past 6 months | |||||||
| Yes | 65 (14.3) | 25 (38.5) | 40 (61.5) | 1.49 (0.97 - 2.31) | 0.0719 | ||
| No | 388 (85.7) | 110 (28.4) | 278 (71.6) | 1 | |||
| Engaged in transactional sex | |||||||
| Yes | 16 (3.5) | 7 (43.8) | 9 (56.3) | 2.06 (0.95 - 4.43) | 0.0657 | ||
| No | 437 (96.5) | 128 (29.3) | 309 (70.7) | 1 | |||
| Received medical care for HIV before | |||||||
| Yes | 92 (22.3) | 13 (14.1) | 79 (85.9) | 1 | |||
| No | 321 (77.7) | 109 (34.0) | 212 (66.0) | 1.56 (0.88 - 2.79) | 0.1278 | ||
| Receiving ART at most recent visit | |||||||
| Yes | 281 (62.0) | 114 (40.6) | 167 (59.4) | 2.54 (1.59 - 4.05) | <.0001 | 3.10 (1.86 - 5.18) | <.0001 |
| No | 172 (38.0) | 21 (12.2) | 151 (87.8) | 1 | 1 | ||
| Baseline viral load (Log10) | |||||||
| Continuous (decrease) | 442 (100.0) | 130 (29.4) | 312 (70.6) | 1.33 (1.15 – 1.56) | 0.0002 | 1.56 (1.32 – 1.89) | <.0001 |
| Person conducting LTC activities | |||||||
| LTC OW | 374 (82.7) | 112 (29.9) | 262 (70.1) | 1 | |||
| Other ATN staff | 16 (3.5) | 4 (25.0) | 12 (75.0) | 1.25 (0.46 - 3.39) | 0.6627 | ||
| Non-ATN staff | 62 (13.7) | 19 (30.6) | 43 (69.4) | 1.67 (1.02 - 2.73) | 0.0401 | ||
| Data sharing plan | |||||||
| Formal data sharing | 98 (21.6) | 16 (16.3) | 82 (83.7) | 1 | 1 | ||
| Limited, Sharing of de-identified information monthly | 141 (31.1) | 47 (33.3) | 94 (66.7) | 3.21 (1.80 - 5.71) | <.0001 | 2.33 (1.22 - 4.47) | 0.0106 |
| No formal, informal, no data sharing, and others | 214 (47.2) | 72 (33.6) | 142 (66.4) | 2.88 (1.67 - 4.99) | 0.0002 | 2.78 (1.51 - 5.11) | 0.0010 |
| Region | |||||||
| 1=Northeast | 34 (7.5) | 14 (41.2) | 20 (58.8) | 1 | |||
| 2=Midwest | 60 (13.2) | 15 (25.0) | 45 (75.0) | 0.51 (0.24 - 1.06) | 0.0718 | ||
| 3=South | 305 (67.3) | 91 (29.8) | 214 (70.2) | 0.79 (0.45 - 1.39) | 0.4092 | ||
| 4=West | 54 (11.9) | 15 (27.8) | 39 (72.2) | 0.51 (0.24 - 1.05) | 0.0687 | ||
| Care interval** | |||||||
| LTC | 12 (2.7) | 1 (8.3) | 11 (91.7) | 1 | 1 | ||
| EIC | 118 (26.2) | 24 (20.3) | 94 (79.7) | 2.16 (0.29 - 16.00) | 0.4521 | 2.30 (0.31 - 17.16) | 0.4175 |
| RIC | 121 (26.8) | 34 (28.1) | 87 (71.9) | 1.40 (0.19 - 10.24) | 0.7406 | 1.53 (0.21 - 11.37) | 0.6757 |
| Post-RIC | 200 (44.3) | 76 (38.0) | 124 (62.0) | 0.50 (0.07 - 3.67) | 0.4974 | 0.49 (0.07 - 3.68) | 0.4882 |
| Time from HIV testing to referral | |||||||
| 0-7 days | 111 (26.2) | 34 (30.6) | 77 (69.4) | 1.17 (0.69 - 1.99) | 0.5569 | 1.64 (0.93 - 2.91) | 0.0883 |
| >7 days to 6 weeks | 146 (34.4) | 50 (34.2) | 96 (65.8) | 1.64 (1.00 - 2.69) | 0.0495 | 2.52 (1.50 - 4.23) | 0.0005 |
| >6 weeks to 3 months | 54 (12.7) | 19 (35.2) | 35 (64.8) | 1.49 (0.81 - 2.75) | 0.1960 | 2.08 (1.08 - 4.04) | 0.0294 |
| >3 months | 113 (26.7) | 23 (20.4) | 90 (79.6) | 1 | 1 | ||
| Time from referral to LTC | |||||||
| Same day (0 day) | 66 (14.6) | 17 (25.8) | 49 (74.2) | 1 | |||
| 1-7 days | 118 (26.2) | 39 (33.1) | 79 (66.9) | 0.90 (0.51 - 1.59) | 0.7110 | ||
| >7 days to <=42 days | 260 (57.6) | 77 (29.6) | 183 (70.4) | 0.84 (0.49 - 1.42) | 0.5129 | ||
| >42 days | 7 (1.6) | 2 (28.6) | 5 (71.4) | 0.75 (0.17 - 3.28) | 0.7054 | ||
| Time from EIC to RIC | |||||||
| 30 days to 3 months | 277 (81.0) | 98 (35.4) | 179 (64.6) | 1 | |||
| >3 months to 6 months | 56 (16.4) | 14 (25.0) | 42 (75.0) | 0.87 (0.49 - 1.55) | 0.6457 | ||
| >6 months to 1 year | 9 (2.6) | 4 (44.4) | 5 (55.6) | 3.37 (1.23 - 9.19) | 0.0178 | ||
BLD: Below limit of detection for the assay being used; LTC: linked to care; EIC: engaged in care; RIC: retained in care; LTC OW: linkage to care outreach worker, also referred to as LTC or linkage coordinator; ATN: Adolescent Medicine Trials Network for HIV/AIDS Interventions; ART: antiretroviral therapy
Substances assessed included alcohol, barbiturates, club drugs, hallucinogens, inhalants, sedative hypnotics, amphetamines, cannabis, cocaine, heroin, methadone, other opiates and street hormones.
Care intervals along the HIV Care Continuum were defined for LTC: a clinical visit attended no later than 42 days after referral for linkage; EIC: at least one additional clinical visit attended no later than 16 weeks after LTC; RIC: at least one additional clinical visit attended no later than 52 weeks after EIC; and, *Post-RIC: a second clinical visit attended within 52 weeks after EIC, if the RIC visit occured early in the interval.
LTC = Linked to Care; VL = Viral Load; STI = Sexually transmitted infection