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BACKGROUND: Achieving virologic suppression remains the important goal for persons living with HIV/AIDS (PLWHA), as low levels of the virus contribute to better health outcomes among HIV-positive populations and reduce overall transmission. Recent studies suggest that certain sociodemographic factors and mental health (MH) disorders may have an effect on virologic suppression among PLWHA, but little research has evaluated which factors can predict virologic outcome among HIV-positive individuals. The objective of this study is to examine if MH disorders (anxiety, bipolar disorder, psychosis, and major depressive disorder) and individual sociodemographic characteristics can predict undetectable virologic outcome in an HIV-positive population.
METHODS: Data are from the 2009, 2010, and 2011 cycles of the Medical Monitoring Project (MMP) in Virginia (N=387). MH disorders and viral load data were collected by review of patient medical records. Sociodemographic factors were assessed by patient interview at time of data collection. Backward elimination multivariate logistic regression was used to determine if there was a predictive relationship between MH diagnosis and sociodemographic factors (selected a priori) and viral suppression.
RESULTS: Among the 387 MMP participants, 43.3% had a documented MH disorder. There was a significant relationship between persons diagnosed with a MH disorder and evidence of a suppressed viral load [x2 (1, 387) = 7.1, p<.01]. Participants diagnosed with an MH disorder were 3.2 times more likely to have a suppressed viral load than those who had no documentation of MH diagnosis [odds ratio (OR): 3.2, 95% confidence interval (CI), 1.4-8.2]. Participants were 1.6 times more likely to be virologically suppressed than individuals who were ten years younger (CI, 1.2-2.3).
CONCLUSIONS: The results suggest that MMP participants who were diagnosed with a MH disorder were more likely to be virologically suppressed than participants without a MH disorder. These findings also indicated potential differences in participant age and rates of virologic suppression. These data strengthen evidence that addressing MH in clinical and public health settings may improve virologic outcomes among HIV-positive patients.