| Author | 
        Year | 
        Study design | 
        Country | 
        Income group | 
        Region | 
        Number analyzed | 
        M (%) | 
        Age (years) | 
        HIV duration (years) | 
        ART (%) | 
        Incarcerated (%) | 
        Homosexual (%) | 
       
      
        | Ajuoga  | 
        2009  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        215  | 
        69  | 
        45 ± 8.3  | 
          | 
          | 
          | 
          | 
       
      
        | Altice  | 
        2011  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        295  | 
        68.1  | 
        45.2 ± 8.2  | 
          | 
        59.7  | 
          | 
        19  | 
       
      
        | Belloso  | 
        2010  | 
        Cohort  | 
        Multiple  | 
        LMIC  | 
        America  | 
        520  | 
          | 
          | 
        5.5 ± 4.4  | 
        80  | 
          | 
          | 
       
      
        | Berg  | 
        2009  | 
        RCT  | 
        USA  | 
        High  | 
        America  | 
        77  | 
        53  | 
        47 ± 6.9  | 
        13 ± 4  | 
        100  | 
          | 
          | 
       
      
        | Bertolaccini  | 
        2008  | 
        Cohort  | 
        Italy  | 
        High  | 
        Europe  | 
        26  | 
        85  | 
        39 ± 6.1  | 
          | 
        85  | 
          | 
        23  | 
       
      
        | Buchacz  | 
        2008  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        7155  | 
        80.5  | 
          | 
          | 
          | 
          | 
        58.5  | 
       
      
        | Castellares  | 
        2008  | 
        Cross-sectional  | 
        Spain  | 
        High  | 
        Europe  | 
        2168  | 
        76.2  | 
        42 ± 6  | 
          | 
          | 
          | 
        34  | 
       
      
        | Chander  | 
        2006  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        1957  | 
        63.7  | 
          | 
          | 
        73.2  | 
          | 
        23.6  | 
       
      
        | Chao  | 
        2012  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        12872  | 
        90  | 
        40.1 ± 9.8  | 
        2.8 ± 4.1  | 
        21.1  | 
          | 
        61.6  | 
       
      
        | Fuster  | 
        2014  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        400  | 
        74.7  | 
        43 ± 7.4  | 
          | 
        62  | 
          | 
          | 
       
      
        | Fuster  | 
        2013  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        308  | 
        73.1  | 
        42.8 ± 7.3  | 
          | 
        60.4  | 
          | 
          | 
       
      
        | Goar  | 
        2011  | 
        Cross-sectional  | 
        Nigeria  | 
        LMIC  | 
        Africa  | 
        160  | 
        35.6  | 
          | 
          | 
          | 
          | 
          | 
       
      
        | Goh  | 
        2007  | 
        Cross-sectional  | 
        Singapore  | 
        High  | 
        W/Pacific  | 
        96  | 
        89.6  | 
        40.2 ± 7.3  | 
          | 
          | 
          | 
        22  | 
       
      
        | Green  | 
        2010  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        3160  | 
        97.5  | 
        49.4 ± 8.8  | 
          | 
          | 
          | 
          | 
       
      
        | Grzeszczuk  | 
        2015  | 
        Cross-sectional  | 
        Poland  | 
        LMIC  | 
        Europe  | 
        457  | 
        76.6  | 
        38 ± 6.1  | 
        10 ± 3.3  | 
          | 
        23.4  | 
        8.8  | 
       
      
        | Hayashi  | 
        2015  | 
        Cross-sectional  | 
        Thailand  | 
        LMIC  | 
        W/Pacific  | 
        128  | 
        80.4  | 
          | 
          | 
        54.7  | 
        93.3  | 
          | 
       
      
        | Helleberg  | 
        2013  | 
        Cohort  | 
        Denmark  | 
        High  | 
        Europe  | 
        2921  | 
        77.5  | 
        43.3 ± 6.6  | 
        7 ± 2.6  | 
        77.4  | 
          | 
        52.9  | 
       
      
        | Hsu  | 
        2013  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        30533  | 
        95.5  | 
        50.3 ± 11  | 
          | 
          | 
          | 
          | 
       
      
        | Ibrahim  | 
        2014  | 
        Cross-sectional  | 
        Nigeria  | 
        LMIC  | 
        Africa  | 
        250  | 
        47.6  | 
          | 
          | 
          | 
          | 
          | 
       
      
        | Ikeda  | 
        2013  | 
        Cross-sectional  | 
        Brazil  | 
        LMIC  | 
        America  | 
        1240  | 
        50.6  | 
        39.1 ± 10  | 
          | 
        65.7  | 
          | 
          | 
       
      
        | Josephs  | 
        2010  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        951  | 
        68  | 
          | 
          | 
        69  | 
          | 
        34  | 
       
      
        | Justice  | 
        2010  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        9784  | 
        97.9  | 
        45  | 
          | 
          | 
          | 
          | 
       
      
        | Kabali  | 
        2011  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        462  | 
        77  | 
          | 
          | 
          | 
          | 
          | 
       
      
        | Kagimu  | 
        2012  | 
        Case-control  | 
        Uganda  | 
        LMIC  | 
        Africa  | 
        106  | 
        18  | 
          | 
          | 
          | 
          | 
          | 
       
      
        | Kellerman  | 
        2003  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        16248  | 
        70.8  | 
          | 
          | 
        47.1  | 
          | 
        38.4  | 
       
      
        | Kellinghaus  | 
        2008  | 
        Cross-sectional  | 
        Germany  | 
        High  | 
        Europe  | 
        51  | 
        74.5  | 
        37 ± 2.5  | 
          | 
        72.6  | 
          | 
          | 
       
      
        | Kim  | 
        2006  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        349  | 
        89.3  | 
        40.7 ± 7.2  | 
          | 
        31.8  | 
        17.8  | 
          | 
       
      
        | Korthuis  | 
        2015  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        3038  | 
        97.5  | 
        49 ± 8.8  | 
          | 
        83.9  | 
          | 
          | 
       
      
        | Korthuis  | 
        2012  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        3410  | 
        97.4  | 
        49.1 ± 8.8  | 
          | 
        83.2  | 
          | 
          | 
       
      | 
  
  
    
      
        | Krupitsky  | 
        2005  | 
        Cross-sectional  | 
        Russia  | 
        High  | 
        Europe  | 
        201  | 
        62  | 
        26.6 ± 8.2  | 
          | 
          | 
          | 
          | 
       
      
        | Lim  | 
        2014  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        2111  | 
        97.7  | 
        48.5 ± 2.5  | 
          | 
        82.6  | 
          | 
          | 
       
      
        | Luo  | 
        2013  | 
        Cross-sectional  | 
        China  | 
        LMIC  | 
        W/Pacific  | 
        551  | 
        66.2  | 
          | 
          | 
        67.5  | 
        9.3  | 
          | 
       
      
        | Mayer  | 
        2010  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        398  | 
        100  | 
        41.5 ± 8.4  | 
        8.6 ± 6.7  | 
        66.1  | 
          | 
        100  | 
       
      
        | Mayer  | 
        2012  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        557  | 
        78.6  | 
        42 ± 2.8  | 
        4.9 ± 1.5  | 
        78  | 
          | 
        65.5  | 
       
      
        | McGinnis  | 
        2013  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        444  | 
         | 
        50 ± 8.4  | 
          | 
          | 
          | 
          | 
       
      
        | Merlin  | 
        2012  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        1521  | 
        42.3  | 
        43.7  | 
          | 
          | 
          | 
        54.9  | 
       
      
        | Merlin  | 
        2013  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        1903  | 
        77.4  | 
        43.6  | 
          | 
          | 
          | 
        52.7  | 
       
      
        | Metsch  | 
        2009  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        1038  | 
        62  | 
          | 
          | 
        42  | 
        31.4  | 
          | 
       
      
        | Miaskowski  | 
        2011  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        296  | 
        70.7  | 
        48.2 ± 7.3  | 
          | 
        74.4  | 
          | 
          | 
       
      
        | Mijch  | 
        2006  | 
        Cohort  | 
        Australia  | 
        High  | 
        W/Pacific  | 
        2981  | 
        93.5  | 
          | 
          | 
          | 
          | 
        4.3  | 
       
      
        | Moore  | 
        2012  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        117  | 
        87.5  | 
        43.7 ± 7.8  | 
          | 
          | 
          | 
          | 
       
      
        | Nahvi  | 
        2012  | 
        RCT  | 
        USA  | 
        High  | 
        America  | 
        77  | 
        53  | 
        47 ± 7  | 
          | 
        100  | 
          | 
          | 
       
      
        | Nakimuli-Mpungu  | 
        2011  | 
        Cross-sectional  | 
        Uganda  | 
        LMIC  | 
        Africa  | 
        500  | 
        30.2  | 
          | 
          | 
          | 
          | 
          | 
       
      
        | Newville  | 
        2015  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        295  | 
        67.8  | 
        47.5 ± 9.7  | 
        11.5  | 
        100  | 
          | 
          | 
       
      
        | Nicolleti  | 
        2007  | 
        Cross-sectional  | 
        Brazil  | 
        LMIC  | 
        America  | 
        385  | 
        70  | 
        37.5 ± 8.6  | 
          | 
        70  | 
          | 
          | 
       
      
        | Nunes  | 
        2006  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        401  | 
        73  | 
          | 
          | 
        59  | 
        23  | 
          | 
       
      | 
  
  
    
      
        | Obel  | 
        2011  | 
        Cohort  | 
        Denmark  | 
        High  | 
        Europe  | 
        2267  | 
        73.9  | 
        40.8 ± 3.6  | 
        5.3  | 
          | 
          | 
        38.5  | 
       
      
        | Omland  | 
        2010  | 
        Cohort  | 
        Denmark  | 
        High  | 
        Europe  | 
        392  | 
        59.5  | 
        39 ± 2.6  | 
        6.5 ± 3  | 
        37.5  | 
          | 
          | 
       
      
        | Pace  | 
        2012  | 
        Cross-sectional  | 
        Russia  | 
        High  | 
        Europe  | 
        682  | 
        60  | 
        30 ± 5.2  | 
          | 
        17.2  | 
        38.1  | 
        2.1  | 
       
      
        | Pakkala  | 
        2012  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        80  | 
        80  | 
        52  | 
          | 
        70  | 
          | 
        19  | 
       
      
        | Pintado  | 
        2001  | 
        Cross-sectional  | 
        Spain  | 
        High  | 
        Europe  | 
        80  | 
        80  | 
          | 
          | 
          | 
          | 
        7.5  | 
       
      
        | Robinson-Papp  | 
        2012  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        636  | 
        77  | 
        41  | 
          | 
          | 
          | 
          | 
       
      
        | Ruan  | 
        2007  | 
        Cohort  | 
        China  | 
        LMIC  | 
        W/Pacific  | 
        229  | 
        82.1  | 
          | 
          | 
          | 
          | 
          | 
       
      
        | Ryan  | 
        2004  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        107  | 
        81.3  | 
        43.5 ± 7.2  | 
          | 
          | 
          | 
          | 
       
      
        | Salmon-Ceron  | 
        2009  | 
        Cohort  | 
        France  | 
        High  | 
        Europe  | 
        898  | 
        75  | 
        46  | 
        11.8  | 
        88  | 
          | 
        26  | 
       
      
        | Sambamoorthi  | 
        2000  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        5559  | 
        54.2  | 
          | 
          | 
        58.8  | 
          | 
          | 
       
      
        | Scribner  | 
        2000  | 
        Case-control  | 
        USA  | 
        High  | 
        America  | 
        75  | 
        89.3  | 
        39.5  | 
          | 
          | 
          | 
        61  | 
       
      
        | Siemieniuk  | 
        2012  | 
        Cross-sectional  | 
        Canada  | 
        High  | 
        America  | 
        687  | 
         | 
        45 ± 10.2  | 
          | 
          | 
        10.5  | 
          | 
       
      
        | Silverberg  | 
        2013  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        4137  | 
        87.6  | 
        47.2 ± 8.8  | 
        10 ± 5.9  | 
        81.1  | 
          | 
        61.6  | 
       
      
        | Sullivan  | 
        2006  | 
        RCT  | 
        USA  | 
        High  | 
        America  | 
        16  | 
        94  | 
        47.2 ± 8.5  | 
          | 
          | 
          | 
          | 
       
      
        | Surrat  | 
        2013  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        503  | 
        59.5  | 
        46.1 ± 7.8  | 
        13.3 ± 7.3  | 
          | 
          | 
       
      
        | Tabarsi  | 
        2012  | 
        Cross-sectional  | 
        Iran  | 
        LMIC  | 
        E/Mediterranean  | 
        111  | 
        96.4  | 
        38 ± 9  | 
          | 
        26.1  | 
        88.1  | 
        0.9  | 
       
      
        | Tetrault  | 
        2012  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        114  | 
        97  | 
        49  | 
          | 
        52  | 
          | 
          | 
       
      
        | Towner  | 
        2012  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        20775  | 
        91  | 
        41  | 
        3.5  | 
        33  | 
          | 
        59  | 
       
      
        | Tsui  | 
        2012  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        397  | 
        74.8  | 
        42.5 ± 7.5  | 
          | 
          | 
          | 
          | 
       
      
        | Tyurina  | 
        2013  | 
        Cohort  | 
        Russia  | 
        High  | 
        Europe  | 
        700  | 
        59.3  | 
        30.1 ± 5.2  | 
          | 
        17.3  | 
          | 
          | 
       
      
        | Vagenas  | 
        2014  | 
        RCT  | 
        USA  | 
        High  | 
        America  | 
        85  | 
        78.8  | 
        46  | 
          | 
        81.2  | 
          | 
          | 
       
      
        | Vallecillo  | 
        2013  | 
        Cross-sectional  | 
        Spain  | 
        High  | 
        Europe  | 
        91  | 
        63.7  | 
        44.5 ± 8  | 
          | 
        74.7  | 
          | 
          | 
       
      | 
  
  
    
      
        | Van der Werf  | 
        2006  | 
        Cross-sectional  | 
        Ukraine  | 
        High  | 
        Europe  | 
        968  | 
        73.6  | 
          | 
          | 
          | 
        12.1  | 
          | 
       
      
        | Vergara-Rodriguez  | 
        2011  | 
        Cohort  | 
        USA  | 
        High  | 
        America  | 
        303  | 
          | 
          | 
          | 
        60  | 
          | 
          | 
       
      
        | Vidrine  | 
        2006  | 
        RCT  | 
        USA  | 
        High  | 
        America  | 
        95  | 
        77.9  | 
        42.9 ± 8.1  | 
          | 
          | 
          | 
        37.9  | 
       
      
        | Whetten  | 
        2012  | 
        Cross-sectional  | 
        USA  | 
        High  | 
        America  | 
        611  | 
        68.7  | 
        40.1 ± 25  | 
          | 
          | 
          | 
        44.5  | 
       
      | 
  
  
  
    | Table 1: Characteristics of eligible studies, ART: antiretroviral therapy; E/Mediterranean: eastern mediterranean; LMIC: low- and middle-income     country; M: males; W/Pacific |