Table 4.
Factors associated with moderate to high risk substance use
| Total patients | Number with moderate to high risk substance use | Univariate | Multivariate | |||||
|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | p | aOR | 95% CI | p | |||
| Total | 864 | 425 | ||||||
| Age at study assessment (years) | 0.002 | 0.008 | ||||||
| ≤ 30 | 203 | 107 | 1 | 1 | ||||
| 31–40 | 270 | 152 | 1.16 | (0.80, 1.67) | 0.438 | 1.24 | (0.84, 1.82) | 0.279 |
| 41–50 | 255 | 112 | 0.70 | (0.49, 1.02) | 0.062 | 0.78 | (0.52, 1.16) | 0.213 |
| > 50 | 136 | 54 | 0.59 | (0.38, 0.92) | 0.019 | 0.60 | (0.37, 0.96) | 0.033 |
| Sex | ||||||||
| Male | 758 | 398 | 1 | 1 | ||||
| Female | 106 | 27 | 0.31 | (0.20, 0.49) | < 0.001 | 0.38 | (0.23, 0.61) | < 0.001 |
| HIV mode of exposure | 0.096 | |||||||
| Heterosexual contact | 276 | 119 | 1 | |||||
| MSM | 460 | 238 | 1.41 | (1.05, 1.91) | 0.024 | |||
| Injecting drug use | 15 | 9 | 1.98 | (0.69, 5.71) | 0.207 | |||
| Other/Unknown | 113 | 59 | 1.44 | (0.93, 2.24) | 0.103 | |||
| Viral load at study assessment (copies/mL) | 0.982 | |||||||
| < 50 | 535 | 256 | 1 | |||||
| 50–399 | 37 | 16 | 0.83 | (0.42, 1.63) | 0.588 | |||
| 400–999 | 4 | 0 | N/A | |||||
| ≥ 1000 | 49 | 25 | 1.14 | (0.63, 2.04) | 0.671 | |||
| Not tested | 239 | 128 | ||||||
| CD4 at study assessment (cells/µL) | 0.179 | |||||||
| ≤ 200 | 73 | 29 | 1 | |||||
| 201–350 | 94 | 49 | 1.65 | (0.89, 3.07) | 0.112 | |||
| 351–500 | 123 | 54 | 1.19 | (0.66, 2.14) | 0.567 | |||
| > 500 | 319 | 163 | 1.59 | (0.94, 2.66) | 0.081 | |||
| Not tested | 255 | 130 | ||||||
| Current ART | 0.270 | |||||||
| NRTI + NNRTI | 455 | 214 | 1 | |||||
| NRTI + PI | 55 | 28 | 1.17 | (0.67, 2.04) | 0.587 | |||
| INSTI | 320 | 163 | 1.17 | (0.88, 1.56) | 0.284 | |||
| Other | 11 | 9 | 5.07 | (1.08, 23.71) | 0.039 | |||
| None/unknown | 23 | 11 | 1.03 | (0.45, 2.39) | 0.941 | |||
| Hepatitis B co-infection | ||||||||
| Negative | 297 | 132 | 1 | |||||
| Positive | 34 | 8 | 0.38 | (0.17, 0.88) | 0.023 | |||
| Not tested | 533 | 285 | ||||||
| Hepatitis C co-infection | ||||||||
| Negative | 410 | 169 | 1 | |||||
| Positive | 30 | 13 | 1.09 | (0.52, 2.30) | 0.821 | |||
| Not tested | 424 | 243 | ||||||
| Prior AIDS diagnosis | ||||||||
| No | 556 | 268 | 1 | |||||
| Yes | 202 | 100 | 1.05 | (0.76, 1.45) | 0.751 | |||
| Not reported | 106 | 57 | ||||||
| Household income (USD) per month | 0.012 | |||||||
| ≤ $500 | 212 | 95 | 1 | |||||
| $501–$2000 | 258 | 112 | 0.94 | (0.66, 1.36) | 0.761 | |||
| > $2000 | 257 | 144 | 1.57 | (1.09, 2.26) | 0.016 | |||
| Not reported/unknown | 137 | 74 | ||||||
| Employment | < 0.001 | < 0.001 | ||||||
| No | 180 | 78 | 0.87 | (0.61, 1.22) | 0.411 | 0.76 | (0.52, 1.12) | 0.168 |
| Full time | 499 | 234 | 1 | 1 | ||||
| Part time | 123 | 79 | 2.03 | (1.35, 3.06) | 0.001 | 2.07 | (1.34, 3.19) | 0.001 |
| Not reported/unknown | 62 | 34 | ||||||
| Highest education level | 0.579 | |||||||
| No education | 4 | 1 | 0.34 | (0.03, 3.25) | 0.346 | |||
| Primary to high school | 277 | 133 | 0.93 | (0.70, 1.24) | 0.622 | |||
| College to university | 562 | 280 | 1 | |||||
| Not reported/unknown | 21 | 11 | ||||||
| HIV disclosure status | 0.025 | 0.007 | ||||||
| Full | 41 | 29 | 1 | 1 | ||||
| Partial | 617 | 302 | 0.40 | (0.20, 0.79) | 0.009 | 0.30 | (0.14, 0.63) | 0.002 |
| None, to no one | 162 | 76 | 0.37 | (0.17, 0.77) | 0.008 | 0.33 | (0.15, 0.74) | 0.007 |
| No response/not reported/unknown | 44 | 18 | ||||||
| Previous stressors | ||||||||
| No | 369 | 156 | 1 | 1 | ||||
| Yes | 437 | 238 | 1.63 | (1.23, 2.16) | 0.001 | 1.63 | (1.21, 2.20) | 0.001 |
| Not reported/unknown | 58 | 31 | ||||||
| Current chronic comorbid condition | ||||||||
| No | 352 | 191 | 1 | |||||
| Yes | 150 | 76 | 0.87 | (0.59, 1.27) | 0.460 | |||
| Not reported/unknown | 362 | 158 | ||||||
| Previous mental health diagnosis | ||||||||
| No | 639 | 297 | 1 | |||||
| Yes | 67 | 39 | 1.60 | (0.96, 2.67) | 0.069 | |||
| Not reported/unknown | 158 | 89 | ||||||
| Family history of mental health diagnoses | ||||||||
| No | 739 | 349 | 1 | |||||
| Yes | 34 | 23 | 2.34 | (1.12, 4.86) | 0.023 | |||
| Not reported/unknown | 91 | 53 | ||||||
| History of STIs in the past 5 years | ||||||||
| No | 413 | 167 | 1 | |||||
| Yes | 263 | 153 | 2.05 | (1.50, 2.80) | < 0.001 | |||
| Not reported/unknown | 188 | 105 | ||||||
| Year of ART initiation | 0.045 | |||||||
| < 2010 | 236 | 97 | 1 | |||||
| 2010–2012 | 115 | 61 | 1.62 | (1.03, 2.54) | 0.035 | |||
| 2013–2015 | 189 | 93 | 1.39 | (0.94, 2.04) | 0.095 | |||
| 2016–2020 | 313 | 169 | 1.68 | (1.20, 2.37) | 0.003 | |||
| No ART/unknown | 11 | 5 | 1.19 | (0.35, 4.02) | 0.775 | |||
| ART adverse events in the previous year | ||||||||
| No | 603 | 290 | 1 | |||||
| Yes | 93 | 41 | 0.85 | (0.55, 1.32) | 0.472 | |||
| Not reported/unknown | 168 | 94 | ||||||
| ART adherence in the previous year | ||||||||
| ≥ 95 | 566 | 259 | 1 | 1 | ||||
| < 95 | 58 | 41 | 2.86 | (1.59, 5.15) | < 0.001 | 2.90 | (1.55, 5.40) | 0.001 |
| Not reported/unknown | 240 | 125 | ||||||
| Moderate to severe depression | ||||||||
| No | 703 | 332 | 1 | |||||
| Yes | 161 | 93 | 1.53 | (1.08, 2.16) | 0.016 | |||
| World Bank country income grouping | ||||||||
| High | 334 | 187 | 1 | 1 | ||||
| Upper-middle and lower-middle | 530 | 238 | 0.64 | (0.49, 0.84) | 0.002 | 0.60 | (0.43, 0.82) | 0.001 |
Not reported values were included in the analysis as a separate category but were excluded from test for heterogeneity
Global p-value forage, viral load, CD4, household income were test for trend
OR odds ratio, aOR adjusted odds ratio, CI confidence interval, ART antiretroviral therapy, STIs sexually transmitted infections, MSM men who have sex with men, NRTI nucleoside reverse transcriptase inhibitors, NNRTI non-NRTI, PI protease inhibitors, INSTI integrase inhibitors