Latent classes of psychosocial conditions, and their associations with recent ART adherence in cisgender Filipino men with HIV who have sex with men
1
Department of Epidemiology and Biostatistics, University of the Philippines Manila, City of Manila, Philippines
2
Department of Epidemiology, Brown University, Providence, RI, United States
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
HIV incidence is rising in the Philippines, signaling an emerging epidemic. Adherence to antiretroviral therapy (ART) is critical for reducing transmission and opportunistic infections, yet local studies report suboptimal adherence among persons with HIV (PWH). Syndemic theory posits that co-occurring psychosocial conditions worsen health outcomes, including ART adherence; thus, this study identified latent classes of psychosocial conditions and examined their associations with recent ART adherence. Methods. We analyzed survey data from 568 cisgender Filipino men with HIV who have sex with men. Nine indicators of psychosocial conditions were assessed: childhood sexual abuse, childhood physical abuse, post-traumatic stress, social anxiety, panic, depressive symptoms, problematic alcohol use, drug use, and polydrug use. Latent class modeling was conducted to identify subgroups characterized by distinct combinations of these conditions. Class membership probabilities were then assigned to participants. Modified Poisson regression models estimated crude and adjusted prevalence ratios (PRs) for poor ART adherence in the past 30 days, with latent class membership as the exposure. Results. Three latent classes emerged - Class 1 (low syndemic; 46.7%) had the lowest prevalence of all psychosocial conditions; Class 2 (low substance use syndemic; 36.6%) had high prevalence of non-substance use psychosocial conditions; Class 3 (high substance use syndemic; 16.7%) had the highest prevalence of substance use. Compared with Class 1, membership in Class 2 (cPR = 2.26; 95% CI: 1.85-2.75) and Class 3 (cPR = 1.88; 95% CI: 1.47-2.40) was associated with higher prevalence of poor ART adherence. After adjustment, only Class 2 versus Class 1 remained significant (aPR = 1.20; 95% CI: 1.02-1.41). Conclusion. Latent class membership reflecting multiple psychosocial conditions was linked to poorer ART adherence, even in the absence of heavy substance use. These findings highlight the need for comprehensive mental health interventions for PWH that go beyond post-HIV test counseling.
HIV incidence is rising in the Philippines, signaling an emerging epidemic. Adherence to antiretroviral therapy (ART) is critical for reducing transmission and opportunistic infections, yet local studies report suboptimal adherence among persons with HIV (PWH). Syndemic theory posits that co-occurring psychosocial conditions worsen health outcomes, including ART adherence; thus, this study identified latent classes of psychosocial conditions and examined their associations with recent ART adherence. Methods. We analyzed survey data from 568 cisgender Filipino men with HIV who have sex with men. Nine indicators of psychosocial conditions were assessed: childhood sexual abuse, childhood physical abuse, post-traumatic stress, social anxiety, panic, depressive symptoms, problematic alcohol use, drug use, and polydrug use. Latent class modeling was conducted to identify subgroups characterized by distinct combinations of these conditions. Class membership probabilities were then assigned to participants. Modified Poisson regression models estimated crude and adjusted prevalence ratios (PRs) for poor ART adherence in the past 30 days, with latent class membership as the exposure. Results. Three latent classes emerged - Class 1 (low syndemic; 46.7%) had the lowest prevalence of all psychosocial conditions; Class 2 (low substance use syndemic; 36.6%) had high prevalence of non-substance use psychosocial conditions; Class 3 (high substance use syndemic; 16.7%) had the highest prevalence of substance use. Compared with Class 1, membership in Class 2 (cPR = 2.26; 95% CI: 1.85-2.75) and Class 3 (cPR = 1.88; 95% CI: 1.47-2.40) was associated with higher prevalence of poor ART adherence. After adjustment, only Class 2 versus Class 1 remained significant (aPR = 1.20; 95% CI: 1.02-1.41). Conclusion. Latent class membership reflecting multiple psychosocial conditions was linked to poorer ART adherence, even in the absence of heavy substance use. These findings highlight the need for comprehensive mental health interventions for PWH that go beyond post-HIV test counseling.
| eISSN: | 2654-1459 |
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