BACKGROUND Hypertension is a significant risk factor for cardiovascular disease, a leading cause of death among people living with HIV (PLWH). Studies suggest that hypertension prevalence among PLWH is high, yet none assess how the 2017 redefinition of hypertension as ≥130/80 rather than the previous standard of ≥140/90 mm Hg will affect prevalence among PLWH. This study addresses this gap. METHODS We examined medical record abstractions of 957 PLWH in Texas from the 2013–2014 Medical Monitoring Project survey. Participants with hypertension were identified by charted diagnosis, antihypertensive medication use, or blood pressure readings ≥140/90 and ≥130/80 mm Hg. Associations with sociodemographic and clinical variables were assessed using Rao–Scott chi-square tests, and odds of having hypertension were calculated using multivariable logistic regression models while adjusting for several demographic and HIV-related variables. RESULTS The 2017 redefinition of hypertension increased prevalence in the sample by 44.3%, from 47.6% to 68.7%. Age group, body mass index, sex, and race remained significantly associated with hypertension (all P < 0.01). Although prevalence was near equal between males and females at ≥140/90 mm Hg (47.4% and 48.5%, respectively), males were 2.36 times more likely to have hypertension than females (95% confidence interval [CI]: 1.55–3.60) at ≥130/80 mm Hg. Prevalence remained comparable between white (73.3%) and black participants (72.9%). CONCLUSIONS This study shows that hypertension prevalence is remarkably high among PLWH and is further increased by updated guidelines. Barriers to hypertension control in the HIV care setting should be identified and addressed to facilitate continued improvement in the quality and length of life for PLWH.
Background People with HIV (PWH) commonly have elevated cholesterol and triglycerides levels that have been linked to medications. However, healthy behaviors including lifestyle changes can lower high cholesterol (CHOL) or high triglycerides (TG), thereby reducing individual risk for cardiovascular diseases. This study aimed to determine the prevalence and risk factors associated with high CHOL or TG among PWH in Texas. Methods Cross-sectional data of 981 PWH from the 2015–2017 Texas and Houston Medical Monitoring Projects were examined. High CHOL or TG was identified by medical chart diagnosis, CHOL or TG medication use, or most recent fasting lab ≥ 200 mg/dl (total CHOL) or ≥ 150 mg/dl (TG). High CHOL or TG associations with sociodemographic and clinical characteristics were assessed using Rao-Scott chi-square tests. Prevalence of high CHOL or TG development was calculated using multivariable logistic regression model. Results High CHOL or TG prevalence was 41% with participants being mostly male (73%), ≥ 40 years (68%), with overweight (31%) or obesity (28%), and virally suppressed (62%). Compared with PWH < 40 years of age, PWH in their 40s, 50s, and ≥ 60s were 57%, 64%, and 62% more likely to have high CHOL or TG, respectively. Participants with overweight and obesity were 41% and 30% more likely to have high CHOL or TG than those with normal weight (BMI: 18.5– < 25), respectively. Conclusion Since high CHOL and TG are modifiable CVD risk factors, increased education and lifestyle modification interventions are warranted to prevent the development of high CHOL or TG among PWH.
Objective(s): To examine the sociodemographic, behavioral, and clinical characteristics associated with 100% ART adherence and sustained viral suppression (SVS) among men who have sex with men (MSM) living with HIV and receiving HIV-related medical care in Texas. Design: A cross-sectional, three-stage design was used to sample jurisdictions, facilities, and HIV patients receiving medical care, using probability-proportional-to-size methods. Methods: Medical record abstraction and interview data (n = 1,426) from the 2009-2014 Medical Monitoring Project (MMP) cycles were used for this analysis. The associations between the sociodemographic, behavioral, and clinical characteristics with both 100% ART adherence and SVS were assessed using Rao-Scott chi-square tests. Multivariable logistic regression models were derived to estimate adjusted prevalence ratios (aPR) and corresponding 95% confidence intervals (CI) for 100% ART adherence and SVS. Results: Of the MSM participants, 84% reported 100% ART adherence and 65% had SVS. Younger (age <55 years) and Black MSM who reported housing/food/income unmet needs were less likely to be 100% ART adherence or attain SVS (p<0.05 for all). Conversely, those who were 100% ART adherent were more likely to have SVS (p<0.05). Compared to MSM ≥55 years, those 18-34, 35-44, and 45-54 years were 34%, 23%, and 15% less likely to achieve SVS, respectively. Additionally, compared to White MSM, Black MSM were 13% less likely to achieve SVS and with adjustment of ART adherence, this association remained statistically significant (p<0.05). MSM who were 100% adherent to ART were 24% more likely to achieve SVS compared to those who were not completely adherent. Conclusions: Our study identified age, race/ethnicity, homelessness, and unmet needs for housing/food/income as major predictors of 100% ART adherence and SVS among MSM living with HIV and receiving medical care in Texas. Since MSM comprise the majority of people living with HIV in Texas, addressing these differences in SVS and ART adherence based on their sociodemographic, behavioral, and HIV-related characteristics is critical to meeting goals set to end the HIV epidemic in Texas.
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