Affiliation:
1. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
2. Corporal Michael J. Crescenz VAMC, Philadelphia, PA, 19104, United States
Abstract
Background:
Improved survivorship among persons living with HIV translates into a
higher risk of medical comorbidities.
Objective :
We assessed the association between the intersection of physical (HIV) and mental
health (psychiatric) conditions and intermediate outcomes.
Methods:
This was a cross-sectional study of the Medical Expenditure Panel Survey (MEPS)-
Household Component between 1996 and 2016. We created four groups for persons aged ≥18: (1)
HIV + psychiatric comorbidity, (2) HIV, (3) psychiatric comorbidity, and (4) no-HIV/no-psychiatric
comorbidity. We compared the burden of medical comorbidities (metabolic disorders, cardiovascular
disease, cancers, infectious diseases, pain, and substance use) among groups using chisquare
tests. We used logistic regression to determine the association between group status and
medical comorbidity.
Results:
Of 218,133,630 (weighted) persons aged ≥18, 0.18% were HIV-positive. Forty-three percent
of the HIV group and 19% of the no-HIV group had psychiatric comorbidities. Half of the
HIV+ psychiatric disorder group had at least one medical comorbidity. Compared to the no-
HIV/no-psychiatric comorbidity group, the HIV + psychiatric comorbidity group had the highest
odds of medical comorbidity (OR= 3.69, 95% CI = 2.99, 4.52).
Conclusion:
Persons presenting with HIV + psychiatric comorbidity had higher odds of medical comorbidities
of pain, cancer, cardiovascular disease, substance use, metabolic disorders and infectious
diseases, beyond that experienced by persons with HIV infection or psychiatric disorders, independently.
Future research will focus on the mediating effects of social determinants and biological
factors on outcomes such as the quality of life, cost and mortality. This will facilitate a shift
away from the single-disease framework and compress morbidity of the aging cohort of HIV-infected
persons.
Funder
Penn Mental Health AIDS Research Center (PMHARC), an NIH
Publisher
Bentham Science Publishers Ltd.
Subject
Virology,Infectious Diseases
Cited by
1 articles.
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