Cover Image
QR Code

Patterns in Mental Health Symptoms, Substance Use, and Viral Suppression in People with HIV: A Clustering Analysis.

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 lear...

Full description

Published in:AIDS & Behavior Vol. 29; no. 11; pp. 3534 - 3544
Main Authors: Hwang, Y. Joseph, Lesko, Catherine R., Pytell, Jarratt D., Falade-Nwulia, Oluwaseun, Jones, Joyce L., Keruly, Jeanne C., Snow, LaQuita N., Moore, Richard D., Fojo, Anthony T.
Format: research tables/charts Journal Article
Published: Springer Nature Nov2025
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188476547&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 188476547
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        10907165
        G1T
      jtl: AIDS & Behavior
      issn: 10907165
      maglogo: N
    pubinfo:
      dt: Nov2025
      vid: 29
      iid: 11
      pid: 237
      pub: Springer Nature
      place: New York, New York
    artinfo:
      ui:
        188476547
        185830765
        188476547
        188476547
        10.1007/s10461-025-04797-6
        188476547
      ppf: 3534
      ppct: 10
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Patterns in Mental Health Symptoms, Substance Use, and Viral Suppression in People with HIV: A Clustering Analysis.
      aug:
        au:
          Hwang, Y. Joseph
          Lesko, Catherine R.
          Pytell, Jarratt D.
          Falade-Nwulia, Oluwaseun
          Jones, Joyce L.
          Keruly, Jeanne C.
          Snow, LaQuita N.
          Moore, Richard D.
          Fojo, Anthony T.
        affil: https://ror.org/00za53h95 Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument Street 2-300, 21287, Baltimore, MD, USA
      sug:
        subj:
          HIV-Positive Persons Psychosocial Factors
          Mental Disorders Epidemiology
          Substance Use Disorders Epidemiology
          Viral Load
          Mental Health
          HIV Infections Complications
          Human
          Male
          Female
          Adult
          Middle Age
          Nonexperimental Studies
          Prospective Studies
          Machine Learning
          Patient-Reported Outcomes
          Clinical Assessment Tools
          Scales
          Questionnaires
          Cluster Analysis
          National Institute on Drug Abuse (U.S.)
          Data Analysis Software
          Logistic Regression
          Descriptive Statistics
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N