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Accordingly, we examined the association and interactions between depression, alcohol use, and recreational drug use on viral suppression among men who have sex with men (MSM) and people who inject drugs (PWID) in India.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MSM and PWID were recruited across India using respondent-driven sampling (RDS). Correlates of viral suppression were determined using Poisson regression models incorporating RDS-II weights. Two-way multiplicative interactions were assessed with separate models of all combinations of the 3 variables of interest using interaction terms; 3-way interactions were evaluated by stratifying 2-way interactions by the third variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1454 treatment-eligible HIV-infected MSM and 1939 PWID, older age (adjusted prevalence ratio [aPR], 1.14 for MSM; 1.41 for PWID) and higher HIV treatment literacy (aPR, 1.58 for MSM; 3.04 for PWID) were positively associated with viral suppression. Among MSM, there was evidence of a synergistic negative association between severe depression and recreational drug use (aPR, 0.37 [95% confidence interval {CI}, .16\u2013.84]), alcohol dependence and recreational drug use (aPR, 0.45 [95% CI, .20\u2013.99]), and severe depression, alcohol dependence, and recreational drug use (aPR, 0.23 [95% CI, .09\u2013.57]). Among PWID, daily injection (aPR, 0.51 [95% CI, .31\u2013.82]) was the primary barrier to suppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Incorporating psychosocial and harm-reduction services into differentiated care models targeting MSM and PWID in low-resource settings is critical to achieving the 90-90-90 HIV\/AIDS targets.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciz175","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T04:30:38Z","timestamp":1551241838000},"page":"304-313","source":"Crossref","is-referenced-by-count":17,"title":["Psychosocial Barriers to Viral Suppression in a Community-based Sample of Human Immunodeficiency Virus\u2013infected Men Who Have Sex With Men and People Who Inject Drugs in India"],"prefix":"10.1093","volume":"70","author":[{"given":"Sandeep","family":"Prabhu","sequence":"first","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"School of Medicine, University of California, San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison M","family":"McFall","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti H","family":"Mehta","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aylur K","family":"Srikrishnan","sequence":"additional","affiliation":[{"name":"Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muniratnam Suresh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santhanam","family":"Anand","sequence":"additional","affiliation":[{"name":"Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saravanan","family":"Shanmugam","sequence":"additional","affiliation":[{"name":"Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D","family":"Celentano","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M","family":"Lucas","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil S","family":"Solomon","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Y.R. 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