Socio‐economic differences in <scp>HIV</scp>/<scp>AIDS</scp> mortality in South Africa

Probst, Charlotte; Parry, Charles D. H.; Rehm, Jürgen

doi:10.1111/tmi.12712

Cited by 26 publications

(24 citation statements)

References 59 publications

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“…People having higher SES usually meant they possess more material (e.g., money, house), human (e.g., skills, knowledge), and social capital (e.g., social support, social network) compared to people with lower SES [5,35]. PLWHA with higher SES usually had lower mortality rate and better prognosis than their low-SES counterparts [3]. How the SES interacted with the association between HIV stigma and psychosocial problems was complex and required a more sophisticated study design to explore the mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…With the advancement and availability of HARRT, HIV/AIDS has transited from a lethal to a manageable chronic disease[1,2]. However, the prognosis differed significantly based upon PLWHA’s socio-economic status (SES) [3,4]. SES is a multi-dimensional and complex measure that has been defined variously in history, from a measurable to an abstract construct that reflects one’s access to collectively desired resources [5].…”

Section: Introductionmentioning

confidence: 99%

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Substance Use and Psychosocial Status among People Living with HIV/AIDS Who Encountered HIV Stigma in China: Stratified Analyses by Socio-Economic Status

Zhang

Liu

et al. 2016

PLoS ONE

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This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s psychosocial status and behaviors of substance use based upon participants’ SES. The impact of HIV stigma differed significantly on psychosocial status across SES gradients. Psychosocial status among people with higher education was more sensitive to HIV stigma compared with PLWHA who were less educated. The odds of substance use behaviors were higher among people with better monthly income than their low-income peers. Our study is the first paper to document the paucity of SES stratified analyses between HIV stigma and psychosocial status and substance use among PLWHA in China. We call for tailored intervention programs to target PLWHA with different backgrounds and characteristics in order to help them to better manage their seropositivity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Substance Use and Psychosocial Status among People Living with HIV/AIDS Who Encountered HIV Stigma in China: Stratified Analyses by Socio-Economic Status

Zhang

Liu

et al. 2016

PLoS ONE

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“…HIV risk is referring to HIV acquired through condom-unprotected sex under the influence of alcohol. Sources: Probst et al 3 , Probst et al 10 , Scott-Sheldon et al 17 , Ahmad et al 32 , Shisana et al 33 , Kehoe et al 36 , Statistics South Africa 44 . AAF, alcohol-attributable fraction; GISHA, Global Information System on Alcohol and Health; SABSSM, South African National HIV Prevalence, Incidence and Behaviour Survey; SES, socioeconomic status.…”

Section: Methodsmentioning

confidence: 99%

“…Persons of low SES were shown to have a higher HIV prevalence, 2 and an at least 1.5 times higher risk of dying from HIV/AIDS compared with persons of high SES. 3 With a Gini index over 60, South Africa is among the countries worldwide where income is most unequally distributed. 4 Not least due to the history of colonialism and apartheid, socioeconomic differences in South Africa are heavily intertwined with race and despite decreasing trends, the average income of a white person is still over 10 times that of a black African person.…”

Section: Introductionmentioning

confidence: 99%

HIV/AIDS mortality attributable to alcohol use in South Africa: a comparative risk assessment by socioeconomic status

2018

Self Cite

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ObjectivesTo quantify HIV/AIDS mortality attributable to alcohol use in the adult general population of South Africa in 2012 by socioeconomic status (SES).DesignComparative risk assessment based on secondary individual data, aggregate data and risk relations reported in the literature.SettingSouth African adult general population.ParticipantsFor metrics of alcohol use by SES, sex and age: 27 070 adults that participated in a nationally representative survey in 2012. For HRs of dying from HIV/AIDS by SES: 87 029 adults that participated in a cohort study (years 2000 to 2014) based out of the Umkhanyakude district, KwaZulu-Natal.Main outcome measuresAlcohol-attributable fractions for HIV/AIDS mortality by SES, age and sex were calculated based on the risk of engaging in condom-unprotected sex under the influence of alcohol and interactions between SES and alcohol use. Age-standardised HIV/AIDS mortality rates attributable to alcohol by SES and sex were estimated using alcohol-attributable fractions and SES-specific and sex-specific death counts. Rate ratios were calculated comparing age-standardised rates in low versus high SES by sex.ResultsThe age-standardised HIV/AIDS mortality rate attributable to alcohol was 31.0 (95% uncertainty interval (UI) 21.6 to 41.3) and 229.6 (95% UI 108.8 to 351.6) deaths per 100 000 adults for men of high and low SES, respectively. For women the respective rates were 10.8 (95% UI 5.5 to 16.1) and 75.5 (95% UI 31.2 to 144.9). The rate ratio was 7.4 (95% UI 3.4 to 13.2) for men and 7.0 (95% UI 2.8 to 18.2) for women. Sensitivity analyses corroborated marked differences in alcohol-attributable HIV/AIDS mortality, with rate ratios between 2.7 (95% UI 0.8 to 7.6; women) and 15.1 (95% UI 6.8 to 27.7; men).ConclusionsThe present study showed that alcohol use contributed considerably to the socioeconomic differences in HIV/AIDS mortality. Targeting HIV infection under the influence of alcohol is a promising strategy for interventions to reduce the HIV/AIDS burden and related socioeconomic differences in South Africa.

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“…Probst et al 22 performed a meta-analysis in order to ascertain the influence of socioeconomic status on the HIV mortality rate in South Africa and observed that lowincome individuals had a 50% higher chance of dying from HIV infection than people with a better economic status. Thus, people receiving a low income constantly deal with limited resources, which may negatively interfere with self-care of the disease.…”

mentioning

confidence: 99%

Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil

Miyada

Garbín

Gatto

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction:In the 1990s, Brazil adopted a public policy that allowed for universal, free access to antiretroviral therapy (ART). Since then, treatment adherence has become a new challenge for administrators of sexually transmitted disease/acquired immunodeficiency syndrome (STD/AIDS) policies. This study quantified adherence to ART and verified whether there is an association between sociodemographic variables and clinical/laboratory data in human immunodeficiency virus (HIV)-infected patients. Methods: This was a cross-sectional, exploratory study with a quantitative approach that was conducted over 8 months.The target population contained patients who were assisted at the ambulatory care facility specialized in STD/AIDS of a mediumsize city located in Northwest São Paulo. In order to verify the level of adherence to ART, a validated CEAT-VIH (Assessment of Adherence to Antiretroviral Therapy Questionnaire) questionnaire was used. Sociodemographic aspects and clinical/laboratory data were obtained from the medical records. The results were analyzed using the Student's t-test and Pearson's coefficient. Results: Herein, 109 patients were interviewed, 56% of whom were male. The age of the population ranged 18-74 years (mean 45.67 years). Adherence to ART was classified as insufficient in 80.7% of cases. There was an association between ART adherence and presence of symptoms and/or opportunistic infection (p=0.008) and economic status (p<0.001). Conclusions: Adherence to ART among HIV carriers cared for by the public health system is low. Patients who reported a favorable economic status and those without symptoms and/or opportunistic infection demonstrated greater treatment adherence than those who needed to take more than 3 pills a day.

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Socio‐economic differences in HIV/AIDS mortality in South Africa

Cited by 26 publications

References 59 publications

Substance Use and Psychosocial Status among People Living with HIV/AIDS Who Encountered HIV Stigma in China: Stratified Analyses by Socio-Economic Status

Substance Use and Psychosocial Status among People Living with HIV/AIDS Who Encountered HIV Stigma in China: Stratified Analyses by Socio-Economic Status

HIV/AIDS mortality attributable to alcohol use in South Africa: a comparative risk assessment by socioeconomic status

Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil

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