Risk Factors for Viral Non-Suppression among People Living with HIV and Major Depressive Disorder in Uganda
Bibliographic record
Abstract
Background: Several studies indicate that depression is associated with non-viral suppression among persons living with HIV (PLWH) using antiretroviral therapy (ART) worldwide. However, among PLWH with major depressive disorder, factors associated with non-viral suppression remain uncertain. We determined the prevalence and identified the factors associated with viral non-suppression among PLWH with major depressive disorder using ART in Northern Uganda. Method: A total of 30 primary care HIV clinics across three northern districts (Gulu, Kitgum, Pader) participated in the study. Using baseline data from the SEEK-GSP study, a cluster-randomized trial in northern Uganda (2016-2019) that involved 1140 PLWH with mild to moderate major depressive disorder; we examined the demographic, clinical, and psychosocial factors using standardized questionnaires. Data on viral load was abstracted from clinic records and dichotomized into suppressed (<1000 viral copies/mL) and non-suppressed (≥1000 viral copies/mL). We used generalized linear regression models to evaluate the factors associated with non-viral suppression. Results: We recruited 1140 PLWH. The viral non-suppression prevalence was 12.2%. In multivariable analysis, the only baseline psychosocial variable independently associated with non-viral suppression was suicide risk (PRR = 1.56, 95% CI: 1.05 - 2.32, p-value = 0.029). The prevalence odds for non-viral suppression were 56% higher among depressed PLWH with moderate to high suicide risk than those with low suicide risk. Among clinical variables, duration on ART ≥ 4 years was independently associated with non-viral suppression (PRR = 1.62, 95% CI: 1.09 - 2.32, p-value = 0.015). Conclusions: Suicide risk and longer duration on ART are associated with non-viral suppression among anti-retroviral therapy users with mild to moderate major depressive disorder in Uganda. As ART is scaled up across Sub-Saharan Africa, first-line psychological care for depression and its complications is urgently needed in established HIV treatment centers.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".