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History of SUD was defined as any prior International Classification of Diseases 9\/10 code for cocaine or opioid disorder. Recent substance use was defined as the self\u2010report of cocaine or non\u2010prescribed opioid use on the National Institute of Drug Abuse\u2010modified Alcohol, Smoking and Substance Involvement Screening Test or clinician\u2010documented cocaine or opioid use abstracted from the medical record. The outcome was viral non\u2010suppression, defined as HIV RNA &gt;200\u2009copies\/mL on the first viral load measurement within 1\u00a0year subsequent to each observation of substance use. We adjusted for birth sex, Black race, age, HIV acquisition risk factors, years in care and CD4 cell count. In secondary analyses, we also adjusted for depressive, anxiety and panic symptoms, cannabis use and cannabis use disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>On their first observation, 31% of patients had a history of an SUD and 18% had recent substance use. Relative to no history of SUD and no recent substance use, the 1\u2010year fully adjusted risk difference (RD) for viral non\u2010suppression associated with cocaine and opioid use disorder and recent substance use was 7.7% (95% CI = 5.3%\u201310.0%), the RD was 5.5% (95% CI = 1.2%\u20139.7%) for history of cocaine use disorder without recent substance use, and the RD was 4.6% (95% CI = 2.7%\u20136.5%) for recent substance use without a SUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Substance use and substance use disorders appear to be highly prevalent among, and independently associated with, viral non\u2010suppression among people with HIV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16301","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T03:03:51Z","timestamp":1690340631000},"page":"2193-2202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Joint effects of substance use disorders and recent substance use on HIV viral non\u2010suppression among people engaged in HIV care in an urban clinic, 2014\u20132019"],"prefix":"10.1111","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1717-2592","authenticated-orcid":false,"given":"Catherine R.","family":"Lesko","sequence":"first","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwaseun O.","family":"Falade\u2010Nwulia","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine  Baltimore Maryland 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