Durable Viral Suppression Among People with HIV and Problem Substance Use in the Era of Universal Antiretroviral Treatment

Margaret M. Paschen-Wolff, Aimee N.C. Campbell, Susan Tross, Tse Hwei Choo, Martina Pavlicova, Sarah Braunstein, Rachael Lazar, Christine Borges, Michael Castro, Hayley Berg, Graham Harriman, Robert H. Remien, Don Des Jarlais

Research output: Contribution to journalArticlepeer-review


This study explored factors associated with durable viral suppression (DVS) among two groups of people living with HIV (PLWH) and problem substance use in the context of universal antiretroviral treatment initiation. Participants (N = 99) were recruited between 2014–2017 from public sexual health clinics [SHC] and a hospital detoxification unit [detox]). DVS (NYC HIV surveillance registry) was defined as two consecutive viral load tests ≤ 200 copies/mL, ≤ 90 days apart, with all other viral loads suppressed over 12 or 18 months. Detox participants were significantly older, with more unstable housing/employment, substance use severity, and longer-term HIV vs. SHC participants. Older age, opioid and stimulant use disorder were significantly associated with lower odds of DVS, while fulltime employment and stable housing were significantly associated with higher odds of DVS at 12-month follow-up. Patterns held at 18-month follow-up. Co-located substance use and HIV services, funding for supportive housing, and collaborative patient-provider relationships could improve DVS among populations with the syndemic of problem substance use, poverty, and long-term HIV.

Original languageEnglish (US)
Pages (from-to)385-396
Number of pages12
JournalAIDS and Behavior
Issue number2
StatePublished - Feb 2022


  • Adherence
  • Antiretroviral therapy
  • Substance use
  • Viral load

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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