ArticleAIDS and behavior2025
Patterns in Mental Health Symptoms, Substance Use, and Viral Suppression in People with HIV: A Clustering Analysis.
Article in AIDS and behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Syndemic Classes of Unhealthy Alcohol Use Reveal Inequities in Alcohol-Related Consequences and HIV Care Outcomes.Alcohol, clinical & experimental research · 2026Article
- Injecting drug use worsens the quality of life in HIV-HCV co-infected patients in Vietnam.Scientific reports · 2026Article
- Quality of life, depression and sexual function in men living with HIV under effective antiretroviral therapy compared with healthy controls.Patient related outcome measures · 2026Article
- Identifying Factors Associated With HIV Viral Suppression and Health Care Outcomes in the Florida Cohort Study Wave 3: Protocol for a Prospective Cohort Study.JMIR research protocols · 2025Article
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Authors and funding
9 authors.
Funding
Abstract
Mental health conditions and substance use are prevalent among people with HIV (PWH), are correlated with one another, and associate with viral non-suppression independently; their joint association with viral non-suppression may be under-studied because of data sparsity. We conducted a machine learning-based clustering analysis to characterize groups of patient-reported mental health symptoms and substance use based on their relationship with HIV viral suppression. Participants in the Johns Hopkins HIV Clinical Cohort reported symptoms of depression, anxiety, and post-traumatic stress, and recent use of alcohol, cocaine, amphetamine, non-prescribed opioids, and cannabis (2013-2023). We fit a random forest model with the viral suppression status as the outcome against self-reported items as predictors and used a forest-derived similarity measure to group participants into three clusters. The cluster with the lowest viral suppression rate (74.5%) had the highest depression symptom score (median score 4, interquartile interval [IQI] 1-8) and anxiety symptom score (median score 2, IQI 0-7) along with the greatest prevalence of recent cocaine (99.9%) and opioid (28.0%) use. The cluster with the highest HIV viral suppression rate (81.1%) had the lowest depression symptom score (median 1, IQI 0-4) and anxiety symptom score (median 0, IQI 0-2) and lowest proportion of recent cocaine (0%) and opioid (2.5%) use. Clinically meaningful groups of PWH with heterogenous mental health and substance use characteristics were formed using a machine learning-based clustering approach. PWH with mental health symptoms and substance use represent an important subpopulation for interventions to improve antiretroviral treatment outcomes.
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