Prevalence and Correlates of Elevated Body Mass Index among HIV-Positive and HIV-Negative Women in the Women's Interagency HIV Study

Abstract

Since the introduction of highly active antiretroviral therapy (HAART) and the subsequent increased life expectancy in HIV-infected persons, non-HIV-related diseases have become an important cause of morbidity and mortality. This cross-sectional study reports the prevalence of overweight and obesity, and sociodemographic, psychological, and substance use-related risk factors for elevated body mass index (BMI) among 2157 HIVseropositive (HIVþ) in comparison to 730 HIV-seronegative (HIVÀ) participants in the Women's Interagency HIV Study (WIHS). Separate univariable and multivariate linear regression analyses were completed for HIVþ and HIVÀ women. Our study revealed a similar proportion of obesity (body mass index [BMI] !30) among HIVþ (33%) and HIVÀ women (29%) ( p ¼ 0.12), as well as comparable median BMI (HIVþ: 26.1 versus HIVÀ: 26.7, p ¼ 0.16). HIVþ compared to HIVÀ women, respectively, were significantly ( p < 0.01) older (median ¼ 35.6 versus. 32.5), but similar ( p ¼ 0.97) by race=ethnicity (57% African American, 28% Hispanic, and 15% white for both). In multivariate models for both HIVþ and HIVÀ women, African American race=ethnicity was significantly ( p < 0.05) associated with higher BMI, while higher quality of life score and illicit hard drug use were associated with lower BMI. Additionally, smoking, alcohol use, markers of advanced HIV infection (AIDS diagnosis, elevated HIV viral load, low CD4 count), and a history of antiretroviral therapy use (ART) were also associated with lower BMI among HIVþ women. In conclusion, risk factors for elevated BMI were similar for HIVþ and HIVÀ women in the WIHS. For HIVþ women, all markers of advanced HIV infection and ART use were additionally associated with lower BMI.

Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity

“…In agreement with the studies of Amorosa et al 46 and Boodram et al 47 , the present study found that smoking was inversely associated with overweight/obesity.…”

Trends and risk factors for obesity among HIV positive Nigerians on antiretroviral therapy

“…Another possible explanation for the observed association of low baseline BMI and obesity may be that the stigma associated with wasting in AIDS patients encourage eating to gain weight in an attempt to obscure the diagnosis of AIDS [18]. The observed association between female gender and obesity in this study is in agreement with previous studies in both the general and HIV infected populations [6][7][8][9]19]. The observed association between low baseline CD4 count less than 350/μl and obesity is in agreement with previous studies showing a correlation between immune reconstitution and increased gain in weight [20,21].…”

Short Communication: From Wasting to Obesity: Initial Antiretroviral Therapy and Weight Gain in HIV-Infected Persons

“…1,9 In addition, HIV-infected females may have rates of overweight/obesity comparable to or higher than HIV-uninfected females. 1,8,10 A greater proportion of HIV-infected females in our cohort was overweight/obese (80% vs. 64.1%) and obese (53% vs. 35.5%) after initial cART …”