Trends in Predictors of Death due to HIV-Related Causes Among Persons Living with AIDS in New York City: 1993-2001

Nash, Denis; Katyal, Monica; Shah, Sarita

doi:10.1093/jurban/jti123

Cited by 36 publications

(33 citation statements)

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“…As strong predictors of death, age [23,24], CD4 cell count [25], and HAART use [1] were evaluated as effect modifiers of the association between smoking and all-cause mortality using the Likelihood Ratio (LR) test. HAART prescription was used as a proxy for HAART use in all analyses as reported HAART use was not consistently available in the ASD dataset.…”

Section: Discussionmentioning

confidence: 99%

Cigarette Smoking and Mortality Among HIV-Infected Individuals in Seattle, Washington (1996–2008)

2010

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HIV-infected individuals with access to highly active antiretroviral therapy (HAART) are living longer and the causes of excess morbidity and mortality among people living with HIV/AIDS (PLWHA) are becoming comparable to individuals without HIV infection. However, many PLWHA smoke cigarettes-a well known contributor to excess morbidity and mortality. To investigate the association between smoking and mortality among PLWHA during the HAART era (1996+), we conducted a retrospective cohort study of 2,108 PLWHA enrolled in Seattle and King County's Adult and Adolescent Spectrum of HIV Disease Study. Adjusted hazard ratios (aHRs) for all-cause and cause-specific mortality were obtained using Cox proportional hazards regression. Compared to never smokers, current smokers (aHR = 1.8, 95% CI: 1.3, 2.3) and individuals with an increased dose and/or duration of smoking were at greater risk of all-cause mortality. Although additional research is needed to evaluate the full effect of smoking on cause-specific mortality, smoking cessation programs should target PLWHA to further increase their life expectancy.

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Section: Discussionmentioning

confidence: 99%

Cigarette Smoking and Mortality Among HIV-Infected Individuals in Seattle, Washington (1996–2008)

2010

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“…Data repeatedly demonstrate that people who regularly utilize HIV primary health care services are more likely to have access to these treatments (e.g., highly active antiretroviral therapy [1][2][3][4][5][6] ), have better indicators of health status, survive longer, [1][2][3] and use acute care services far less. [7][8][9][10] Optimal HIV health care utilization patterns include receipt of regular HIV primary care to monitor CD4 count and viral load, manage other comorbid illnesses, adjust medications, and encourage adherence.…”

Section: Introductionmentioning

confidence: 99%

Gender Disparities in HIV Health Care Utilization among the Severely Disadvantaged: Can We Determine the Reasons?

Sohler

Cunningham

2009

AIDS Patient Care and STDs

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Data repeatedly demonstrate that HIV-infected people who regularly utilize primary health care services are more likely to have access to lifesaving treatments (including antiretroviral medications); have better indicators of health status; survive longer; and use acute care services far less. Women tend to have poorer HIV outcomes than men, which is likely due to gender disparities in optimal utilization of HIV primary care services. To understand the relationship between gender and the HIV health care system, we collected interview and medical record data between August 12, 2004 and June 7, 2005 from 414 severely marginalized, HIV-infected people in New York City and examined whether gender-related disparities in HIV health care utilization existed, and, if so, whether these patterns were explained by patient sociodemographic=behavioral characteristics and=or attitudes toward the health care system and providers. Women were significantly less likely to have optimal HIV health care services utilization, including lower use of HIV primary care services (odds ratio [OR] ¼ 0.56, 95% confidence interval [CI] ¼ 0.35, 0.90) and greater use of the emergency department (OR ¼ 2.13, 95% CI ¼ 1.31, 3.46). Although we identified several factors associated with suboptimal HIV health care services utilization patterns in addition to female gender (low education, insurance status, mistrust of the health care system, and poor trust in health care providers), we were unable to identify factors that explained the observed gender disparities. We conclude that gender disparities in HIV health care utilization are due to a complex array of factors, which require more qualitative and quantitative research attention. Development of intervention strategies that specifically target severely disadvantaged women's HIV health care utilization is in great need.

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“…Survival among persons with HIV infection has improved substantially in NYC, particularly among MSM, since the introduction of highly active antiretroviral therapy (HAART) in 1995. 9,10 The incidence of HIV infection among MSM was recently estimated to be 2.5% per year; 11 however, there are no historical data on HIV incidence to suggest whether it is stable, increasing, or declining. Since June 2000, the NYC Department of Health and Mental Hygiene (DOHMH) has been conducting name-based surveillance to track diagnoses of HIV (non-AIDS) and AIDS among NYC residents.…”

Section: Introductionmentioning

confidence: 99%

Estimation of HIV Prevalence, Risk Factors, and Testing Frequency among Sexually Active Men Who Have Sex with Men, Aged 18–64 Years—New York City, 2002

et al. 2007

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Population-based estimates of human immunodeficiency virus (HIV) prevalence and risk behaviors among men who have sex with men (MSM) are valuable for HIV prevention planning but not widely available, especially at the local level. We combined two population-based data sources to estimate prevalence of diagnosed HIV infection, HIV-associated risk-behaviors, and HIV testing patterns among sexually active MSM in New York City (NYC). HIV/AIDS surveillance data were used to determine the number of living males reporting a history of sex with men who had been diagnosed in NYC with HIV infection through 2002 (23% of HIV-infected males did not have HIV transmission risk information available). Sexual behavior data from a cross-sectional telephone survey were used to estimate the number of sexually active MSM in NYC in 2002. Prevalence of diagnosed HIV infection was estimated using the ratio of HIV-infected MSM to sexually active MSM. The estimated base prevalence of diagnosed HIV infection was 8.4% overall (95% confidence interval [CI] = 7.5-9.6). Diagnosed HIV prevalence was highest among MSM who were non-Hispanic black (12.6%, 95% CI = 9.8-17.6), aged 35-44 (12.6%, 95% CI = 10.4-15.9), or 45-54 years (13.1%, 95% CI = 10.2-18.3), and residents of Manhattan (17.7%, 95% CI = 14.5-22.8). Overall, 37% (95% CI = 32-43%) of MSM reported using a condom at last sex, and 34% (95% CI = 28-39%) reported being tested for HIV in the past year. Estimates derived through sensitivity analyses (assigning a range of HIV-infected males with no reported risk information as MSM) yielded higher diagnosed HIV prevalence estimates (11.0-13.2%). Accounting for additional undiagnosed HIV-infected MSM yielded even higher prevalence estimates. The high prevalence of diagnosed HIV among sexually active MSM in NYC is likely due to a combination of high incidence over the course of the epidemic and prolonged survival in the era of highly active antiretroviral therapy. Despite high HIV prevalence in this population, condom use and HIV testing are low. Combining complementary population-based data sources can provide critical HIV-related information to guide prevention efforts. Individual counseling and education interventions should focus on increasing condom use and encouraging safer At the time this work was conducted, Manning and Marx were with the

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Trends in Predictors of Death due to HIV-Related Causes Among Persons Living with AIDS in New York City: 1993-2001

Abstract: To examine trends in predictors of HIV-related mortality among cohorts of persons living with AIDS (PLWA) in New York

Cited by 36 publications

References 34 publications

Cigarette Smoking and Mortality Among HIV-Infected Individuals in Seattle, Washington (1996–2008)

Cigarette Smoking and Mortality Among HIV-Infected Individuals in Seattle, Washington (1996–2008)

Gender Disparities in HIV Health Care Utilization among the Severely Disadvantaged: Can We Determine the Reasons?

Estimation of HIV Prevalence, Risk Factors, and Testing Frequency among Sexually Active Men Who Have Sex with Men, Aged 18–64 Years—New York City, 2002

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