Research Assistant Professor, University of South Florida
Assessing the relationship between substance use and viral suppression among MSM living with HIV
Antiretroviral therapy (ART) has improved significantly over the past several years and has helped to improve the quality of life for populations living with HIV (PLHIV). Nevertheless, near-perfect adherence is needed to achieve viral suppression. Substance use is common among PLHIV and has been linked to lower adherence to ART. Therefore, substance use may play a significant role in the lower likelihood of achieving viral suppression. However, research assessing this relationship is sparse. The objective of this study was to determine if substance use at baseline was associated with self-reported viral suppression over 12 months. Data were obtained from 337 MSM who participated in a longitudinal disclosure intervention study. Substance use was measured using the Substance Abuse and Mental Illness Symptoms Screener and was operationalized by summing scores on all seven items. Growth curve models were used to determine the association between substance use and self-reported viral suppression over five time points. The longitudinal analysis showed that viral suppression among participants did not change over time. Therefore, logistic regression using only baseline data was used to determine the association between substance use and viral suppression at one time-point. After adjusting for age, race/ethnicity, income, education, employment and time since diagnosis, every increase in substance use score was associated with an 8% decrease in the likelihood of being virally suppressed (adjusted OR: 0.92; 95% CI: 0.87 – 0.98). These findings suggest that substance use treatment components should be included in intervention programs geared towards improving viral suppression among MSM living with HIV.
Abstract: HIV continues to disproportionately affect men who have sex with men (MSM). Depression and substance use have been shown to be risk factors of partner violence among male same-sex couples. However, research exploring the risk factors for partner violence victimization after HIV disclosure among MSM is limited. The aim of this study was to determine the association between depressive symptoms, substance use, and disclosure-associated verbal and/or physical violence from a partner among MSM. Data were obtained from 340 HIV-positive MSM. Multivariable logistic regression was used to determine the associations between Center for Epidemiologic Studies-Depression and substance use scores, and disclosure-associated partner violence. After adjusting for age and income, every one-unit increase in substance use scores resulted in a 9 % (OR 1.09; 95 % CI 1.01-1.16) increase in the odds of disclosure-associated partner violence. HIV disclosure interventions for MSM populations should address substance use and potential violence from partners after disclosure.
Pub.: 01 Jul '15, Pinned: 19 Jun '17
Abstract: Sexual compulsivity is operationalized by engaging in repetitive sexual acts, having multiple sexual partners and/or the excessive use of pornography. Outcome expectancy refers to the beliefs about the consequences of engaging in a given behavior. Research examining the relationship between outcome expectancy and sexual compulsivity is limited. The aim of this study was to assess the association between outcome expectancy and sexual compulsivity among men who have sex with men (MSM) living with HIV. Data were obtained from 338 MSM. Simple and multiple linear regression models were used to assess the association between outcome expectancy and sexual compulsivity. After adjusting for age, race/ethnicity, income, education, and employment status, for every one point increase in outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices, there was, on average, an approximate one point decrease in sexual compulsivity score. Prevention and intervention programs geared towards reducing sexual compulsivity among MSM should focus on increasing outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices.
Pub.: 17 Mar '16, Pinned: 19 Jun '17
Abstract: Vengeance has been shown to be a risk factor for HIV nondisclosure. Research examining the associations between vengeance, condomless sex, and HIV nondisclosure is lacking. The aim of the current study was to explore the association between vengeance, condomless sex and disclosure (behavior, attitude and intention) among men who have sex with men (MSM) living with HIV. Participants included 266 MSM who were a part of a disclosure intervention study. Men were recruited from local and state AIDS service organizations (ASOs), HIV-related venues and forums, and at local eating and drinking establishments in Tampa, Florida, and Columbus and Dayton, Ohio metropolitan statistical areas (MSAs). Advertisements were also placed in local daily newspapers. Vengeance was operationalized into three groups based on percentiles (least, more, and most vengeful) and as a continuous variable. Crude and multivariable logistic regression models were used to examine the association between vengeance and condomless sex in the past 30 days. Simple and multiple linear regression models were used to determine the association between vengeance and HIV disclosure. After adjusting for demographic and geographic characteristics, participants who were "most vengeful" had, on average, an approximate six-point decrease (β: -5.46; 95% CI -9.55, -1.36) in disclosure intention compared to MSM who were "least vengeful." Prevention and intervention programs geared towards improving disclosure among MSM should address vengeance.
Pub.: 19 Dec '16, Pinned: 19 Jun '17