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AIDS Behav. 2018 Oct;22(10):3117-3129. doi: 10.1007/s10461-018-2055-z.

Psychiatric Illness, Substance Use, and Viral Suppression Among HIV-Positive Men of Color Who Have Sex with Men in Los Angeles.

Author information

1
Department of Biostatistics, University of California Los Angeles (UCLA) Fielding School of Public Health, 650 Charles E. Young Dr. South, 51-254 CHS, Los Angeles, CA, 90095-1772, USA. haralis@mednet.ucla.edu.
2
Department of Family Medicine, David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA, USA.
3
University of California Los Angeles (UCLA) Center for HIV Identification, Prevention and Treatment Services (CHIPTS), Los Angeles, CA, USA.
4
Department of Biostatistics, University of California Los Angeles (UCLA) Fielding School of Public Health, 650 Charles E. Young Dr. South, 51-254 CHS, Los Angeles, CA, 90095-1772, USA.
5
Los Angeles LGBT Center, Los Angeles, CA, USA.
6
Department of Epidemiology, University of California Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, CA, USA.
7
Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA, USA.

Abstract

For individuals living with human immunodeficiency virus (HIV), viral suppression positively affects quality and length of life and reduces risks for HIV transmission. Men of color who have sex with men (MoCSM) who have been diagnosed with HIV have disproportionately low rates of viral suppression, with concomitant increases in incidence. We identified specific social, structural, and psychiatric factors associated with viral suppression among a sample of 155 HIV-positive MoCSM. Cigarette smoking and biological markers of recent drug use were significantly associated with detectable viral load. In contrast, individuals reporting a history of psychiatric illness during medical examination were more likely to be virally suppressed. Further analyses demonstrated that psychiatric illness may affect virologic outcomes through increased probability of being prescribed HIV medications. Alternatively, cigarette smoking and drug use appear to negatively affect subsequent HIV Care Continuum milestones such as medication adherence. Findings provide support for comprehensive intervention programs that emphasize prevention and treatment of cigarette, methamphetamine, and other drug use, and promote improved connection to psychiatric care. Continual achievement of this goal may be a crucial step to increase rates of viral suppression and slow HIV incidence in communities of MoCSM in Los Angeles and other urban areas.

KEYWORDS:

Cigarette smoking; MSM; Minority; Psychiatric illness; Viral suppression

PMID:
29478146
PMCID:
PMC6497144
DOI:
10.1007/s10461-018-2055-z
[Indexed for MEDLINE]
Free PMC Article

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